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Characteristics of fracture and related factors in patients with rheumatoid arthritis

  • Original Article
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Modern Rheumatology

Abstract

To examine the clinical features of vertebral and non-vertebral fractures in patients with rheumatoid arthritis (RA), including insufficiency fractures, and to assess the risk factors for fracture, we prospectively studied 209 outpatients with rheumatoid arthritis for 1 year. The age, gender, Steinbrocker’s functional class, glucocorticoid use, history of lower limb surgery, serum C-reactive protein (CRP), and use of bisphosphonates were evaluated. Examination for fractures was performed by radiography, computed tomography (CT), magnetic resonance imaging (MRI), and bone scanning. Thirty-three fractures occurred in 24 patients over the 1-year study period, and the incidence was 15.8 fractures per 100 patient-years. Fractures occurred at various sites. The majority (70%) was insufficiency fracture, and more than 50% caused ambulatory dysfunction. Radiographic findings were absent in 39% of the fractures at the onset of pain. The functional class and glucocorticoid dose were significantly associated with fracture development. This prospective study showed that the incidence of fractures, especially insufficiency fractures, was very high in patients with rheumatoid arthritis and that most of their fractures caused gait disturbance. Early intervention to prevent secondary osteoporosis is recommended to maintain the quality of life in patients with rheumatoid arthritis, especially those with functional impairment or undergoing glucocorticoid therapy.

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Acknowledgments

This work was supported by a Health Science Research Grant from the Ministry of Health and Welfare of Japan.

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Authors and Affiliations

  1. Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan

    Akihide Nampei, Jun Hashimoto, Junichiro Koyanagi, Takeshi Ono, Hideo Hashimoto, Noriyuki Tsumaki, Tetsuya Tomita, Kazuomi Sugamoto & Hideki Yoshikawa

  2. Laboratory of Immune Regulation, Osaka University Graduate School of Frontier Bioscience, 1-3 Yamadaoka, Suita, 565-0871, Japan

    Norihiro Nishimoto

  3. Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan

    Takahiro Ochi

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  1. Akihide Nampei
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  2. Jun Hashimoto
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  3. Junichiro Koyanagi
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Correspondence to Jun Hashimoto.

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Nampei, A., Hashimoto, J., Koyanagi, J. et al. Characteristics of fracture and related factors in patients with rheumatoid arthritis. Mod Rheumatol 18, 170–176 (2008). https://doi.org/10.1007/s10165-008-0032-5

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  • DOI: https://doi.org/10.1007/s10165-008-0032-5

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