Osteoporosis in Rheumatoid Arthritis in Relation to Age

Abstract

Rheumatoid arthritis (RA) is associated with development of a chronic inflammatory process affecting the synovium of joints. Although the disease is caused mainly by focal involvement of joints, it is unquestionably a systemic disorder and the inflammatory process may affect the entire skeleton. In RA, bone may be affected by structural joint damage (bone erosions) in combination with development of juxta-articular osteopenia and osteoporosis that are the major radiodiagnostic signs included in classification criteria for rheumatoid arthritis. In RA patients, the incidence of osteoporosis has been found out to be twice as high as in healthy population [1]. Osteoporosis increases the risk of fractures and, consequently, the morbidity and mortality rate. The causes of osteoporosis associated with RA are numerous, and in addition to primary risk factors, they include also inflammation, immobilisation and glucocorticoid treatment. Quantitative determination of periarticular and generalised bone loss may be in future reliable indicators of further progress of the disease. The main risk factors of development of osteoporosis and fractures associated with RA include duration of the disease, severity of its course, extent of immobilisation, age, female sex and use of glucocorticoids. It has been found out that the incidence of osteoporosis is twice as high in RA female patients of all age categories [1–3].