Abstract
Bone loss has been recognized as a complication of the rheumatoid process for more than a century. Barwel was the first to apply the term “osteoporosis” to the bone disease in rheumatoid arthritis (RA) [1]. Osteoporosis, as recognized by Soila [2], McConkey et al. [3], Saville and Kharmosh [4] and Kennedy and Lindsay [5], may be localized, occurring close to the site of inflamed joints, or generalized, involving the whole skeleton.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Barwel H. Disease of the joints. London: Hardwick, 1865.
Soila P. Roentgen manifestations of adult rheumatoid arthritis. Acta Rheumatol Scand 1985;Suppl 1.
McConckey B, Frazer G, Eligh A. Transparent skin and osteoporosis. A study in patients with rheumatoid disease. Ann Rheum Dis 1965;24:219–223.
Saville PD, Kharmosh P. Osteoporosis of rheumatoid arthritis: influence of age, sex and corticosteroids. Arthritis Rheum 1967;10:423–430.
Kennedy AC, Lindsay R. Bone involvement in rheumatoid arthritis. Clin Rheum Dis 1977;3:403–420.
Bijlsma JWJ. Bone metabolism in patients with rheumatoid arthritis. Clin Rheumatol 1988;7:16–23.
Dequeker J, Geusens P. Osteoporosis and arthritis. Ann Rheum Dis 1990;49:276–280.
Mbuyi JM, Dequeker J, Teblick M, Merlevede M. Relevance of urinary excretion of alcian blue glycosaminoglycan complexes and hydroxyproline to disease activity in rheumatoid arthritis. J Rheumatol 1982;9:579–583.
Gevers G, Devos P, De Roo M, Dequeker J. Increased levels of osteocalcin (serum bone gla protein) in rheumatoid arthritis. Br J Rheumatol 1986;25:260–262.
Verstraeten A, Dequeker J. Mineral metabolism in postmenopausal women with active rheumatoid arthritis. J Rheumatol 1986;13:43–46.
Gough AKS, Peel NFA, Eastell R, Holder RL, Lilley J, Emery P. Excretion of pyridinium crosslinks correlates with disease activity and appendicular bone loss in early rheumatoid arthritis. Ann Rheum Dis 1994;53:14–17.
Gough A, Sambrook P, Devlin J, Huissoon A, Njeh C, Robbins S, et al. Osteoclastic activation is the principal mechanism leading to secondary osteoporosis in rheumatoid arthritis. J Rheumatol 1998;25:1282–1289.
Oelzner P, Müller A, Deschner F, Hüller M, Abendroth K, Hein G, et al. Relationship between disease activity and serum levels of vitamin D metabolites and PTH in rheumatoid arthritis. Calcif Tissue Int 1998;62:193–198.
Westhovens R, Nijs J, Taelman V, Dequeker J. Body composition in rheumatoid arthritis. Br J Rheumatol 1997;36:444–448.
KrÖger H, Honkanen R, Saarikoski S, Alhava E. Decreased axial bone mineral density in perimenopausal women with rheumatoid arthritis: a population based study. Ann Rheum Dis 1994;53:18–23.
Lane NE, Pressman AR, Star VL, Cummings SR, Nevitt MC, and the Study of Osteoporotic Fractures Research Group. Rheumatoid arthritis and bone mineral density in elderly women. J Bone Miner Res 1995;10:257–263.
Hall GM, Spector TD, Griffin AJ, Jawad ASM, Hall ML, Doyle DV. The effect of rheumatoid arthritis and steroid therapy on bone density in postmenopausal women. Arthritis Rheum 1993;36:1510–1516.
Garton MJ, Reid DM. Bone mineral density of the hip and of the anteroposterior and lateral dimensions of the spine in men with rheumatoid arthritis. Arthritis Rheum 1993;36:222–228.
Towheed TE, Brouillard D, Yendt E, Anastassiades T. Osteoporosis in rheumatoid arthritis: findings in the metacarpals, spine and hip and a study of the determinants of both localized and generalized osteoporosis. J Rheumatol 1995;22:440–443.
Hansen M, Florescu A, Stoltenberg M, Podenphant J, Pedersen-Zbinden B, Horslev-Petersen K, et al. Bone loss in rheumatoid arthritis. Scand J Rheumatol 1996;25:367–376.
Martin JC, Munro R, Campbell MK, Reid DM. Effects of disease and corticosteroids on appendicular bone mass in postmenopausal women with rheumatoid arthritis: comparison with axial measurements. Br J Rheumatol 1997;36:43–49.
Mbuyi-Muamba JM, Dequeker J, Burssens A. Massive osteolysis in a case of rheumatoid arthritis: clinical, histologic and biochemical findings. Metab Bone Dis Rel Res 1983;5:101–106.
Compston JE, Crawley EO, Evans C, O’Sullivan MM. Spinal trabecular bone mineral content in patients with non-steroid treated rheumatoid arthritis. Ann Rheum Dis 1988;47:660–664.
Gough AKS, Lilley J, Eyre S, Holder RL, Emery P. Generalised bone loss in patients with early rheumatoid arthritis. Lancet 1994;344:23–27.
Eastgate JA, Wood NC, Di Giovine FS, Symons JA, Grinlinton FM, Duff GW. Correlation of plasma interleukin 1 levels with disease activity in rheumatoid arthritis. Lancet 1988;11:706–709.
Dequeker J, Wielandts L, Koentges D, Nijs J. The assessment of bone loss in rheumatoid arthritis. In: Feltkamp TEW, van der Korst JK, editors. Disease evaluation and assessment in rheumatoid arthritis. Alphen aan den Rijn/Brussels: Stafleu’s Scientific Publishing Company, 1979:54–63.
Verstraeten A, Dequeker J. Vertebral and peripheral bone mineral content and fracture incidence in postmenopausal patients with rheumatoid arthritis: effect of low dose corticosteroids. Ann Rheum Dis 1986;45:852–857.
Sambrook PN, Ansell BM, Foster S, Gumpel JM, Hesp R, Reeve J. Bone turnover in early rheumatoid arthritis. 2. Longitudinal bone density studies. Ann Rheum Dis 1985;44:580–584.
Chan E, Pandith V, Towheed TE, Brouillard D, Zee B, Anastassiades TP. Comparison of the combined cortical thickness of the second metacarpal with Sharp’s method for scoring hand microradiographs in rheumatoid arthritis. J Rheumatol 1998;25: 1290–1294.
Peel NFA, Spittlehouse AJ, Bas DE, Eastell R. Bone mineral density of the hand in rheumatoid arthritis. Arthritis Rheum 1994;37:983–991.
Duff GW. Immune diseases: many roles for interleukin 1. Nature 1985;313:352–353.
Manolagas SC, Jilka RL. Bone marrow, cytokines and bone remodeling. N Engl J Med 1995;332:305–311.
Thomson BM, Mundy GR, Chambers TJ. Tumor necrosis factors a and ß induce osteoblastic cells to stimulate osteoclastic bone resorption. J Immunol 1987; 138: 775–779.
Lems WF, Dijkmans BAC. Should we look for osteoporosis in patients with rheumatoid arthritis? Ann Rheum Dis 1998;57:325–327.
Hooyman JR, Melton LJ, Nelson AM, O’Fallon WM, Riggs BL. Fractures after rheumatoid arthritis. Arthritis Rheum 1984;27:1353–1361.
Cooper C, Coupland C, Mitchell M. Rheumatoid arthritis, corticosteroid-therapy and hip fracture. Ann Rheum Dis 1995;54:49–52.
Spector TD, Hall GM, McCloskey EV, Kanis JA. Risk of vertebral fracture in women with rheumatoid arthritis. BMJ 1993;306:58.
Michel BA, Bloch DA, Fries JF. Predictors of fractures in early rheumatoid arthritis. J Rheumatol 1991;18:804–808.
Cooper C, Carbone L, Michet CJ, Atkinson EJ, O’Fallon WM, Melton LJ III. Fracture risk in patients with ankylosing spondylitis: a population based study. J Rheumatol 1994;21:1877–1882.
Dequeker J, Panayi G, Pincus T, Grahame R. Polyarthritis: rheumatoid arthritis and related conditions. In: Dequeker J, Panayi G, Pincus T, Grahame R, editors. Medical management of rheumatic musculoskeletal and connective tissue diseases. New York: Marcel Dekker, 1997:101–152.
Boden SD, Dodge LD, Bohlman HH, Rechtine GR. Rheumatoid arthritis of the cervical spine. J Bone Joint Surg Am 1993;75:1282–1297.
Casey ATH, Crockard HA, Bland JM, Stevens J, Moskovich R, Ransford AO. Surgery on the rheumatoid cervical spine for the non-ambulant myelopathic patient: too much, too late ? Lancet 1996;347:1004–1007.
Crockard HA. Surgical management of cervical rheumatoid problems. Spine 1995;20: 2584–2590.
Lesoin F, Duquesnoy B, Destee A, Leys D, Rousseaux M, Carini S, et al. Cervical neurological complications of rheumatoid arthritis. Surgical treatment techniques and indications. Acta Neurochir 1985;78:91–97.
Santavirta S, Slätis P, Kankaanpää U, Sandelin J, Laasonen E. Treatment of the cervical spine in rheumatoid arthritis. J Bone Joint Surg Am 1988;70:658–667.
Buckley LM, Leib ES, Cartularo KS, Vacek PM, Cooper SM. The effects of low dose corticosteroids on the bone mineral density of patients with rheumatoid arthritis. J Rheumatol 1995;22:1055–1059.
Laan RFJM, Van Riel PLCM, Erning LITHO, Lemmens JAM, Ruijs SHJ, Van de Putte LBA. Vertebral osteoporosis in rheumatoid arthritis patients: effect of low dose prednisone therapy. Br J Rheumatol 1992;31:91–96.
Laan RFJM, Van Riel PLCM, Van de Putte LBA, Van Erning LITHO, Van’t Hof MA, Lemmens JAM. Low-dose prednisone induces rapid reversible axial bone loss in patients with rheumatoid arthritis. Ann Intern Med 1993;119:963–968.
Nagant de Deuxchaisnes C, Devogelaer JP, Huaux JP. Influence of the menopausal state and the effect of low-dose glucocorticoids on bone mass in rheumatoid arthritis patients. Arthritis Rheum 1986;29:693–694.
Dykman TR, Gluck OS, Murphy WA, Hahn TJ, Hahn BH. Evaluation of factors associated with glucocorticoid-induced osteopenia in patients with rheumatic diseases. Arthritis Rheum 1985;28:361–368.
Nagant de Deuxchaisnes C, Devogelaer JP, Esselinckx W, Bouchez B, Depresseux G, Rombouts-Lindemans C, et al. The effect of low dosage glucocorticoids on bone mass in rheumatoid arthritis: a cross-sectional and a longitudinal study using single photon absorptiometry. Adv Exp Med Biol 1984;171:209–239.
Sambrook PN, Cohen ML, Eisman JA, Pocock NA, Champion GD, Yeates MG. Effects
of low dose corticosteroids on bone mass in rheumatoid arthritis: a longitudinal study. Ann Rheum Dis 1989;48:535–538.
Reid DM, Kennedy NSJ, Smith MA, Nicoli J, Brown N, Tothill P, et al. Bone loss in rheumatoid arthritis and primary generalized osteoarthrosis: effects of corticosteroids, suppressive antirheumatic drugs and calcium supplements. Br J Rheumatol 1986;25: 253–259.
Dequeker J, Westhovens R. Low dose corticosteroid associated osteoporosis in rheumatoid arthritis and its prophylaxis and treatment: bones of contention. J Rheumatol 1995;22:1013–1019.
Karantanas AH, Kalef-Ezra J, Glaros D. Limitations of quantitative CT in corticosteroid induced osteopenia. Acta Radiol 1991;32:339–341.
Manning P, Evans MC, Reid IR. Axial bone density following cure of Cushing’s syndrome: Evidence for reversibility of steroid osteoporosis. In: Christiansen C, Overgaard K, editors. Osteoporosis. Copenhagen: Osteopress, 1990:1585–1586.
Pearce G, Ryan PFJ, Delmas PD, Tabensky DA, Seeman E. The deleterious effects of low-dose corticosteroids on bone density in patients with polymyalgia rheumatica. Br J Rheumatol 1998;37:292–299.
Saito JK, Davis JW, Wasnich RD, Ross PD. Users of low-dose glucocorticoids have increased bone loss rates: a longitudinal study. Calcif Tissue Int 1995;57:115–119.
Emkey RD, Lindsay R, Lyssy J, Weisberg JS, Dempster DW, Shen V. The systemic effect of intraarticular administration of corticosteroid on markers of bone formation and bone resorption in patients with rheumatoid arthritis. Arthritis Rheum 1996;39:277–282.
Geusens P, Dequeker J. Locomotor side-effects of corticosteroids. Baillieres Clin Rheumatol 1991;5:99–118.
Dequeker J. Kortikoide, Knochenmasse und Frakturen bei rheumatischen Erkrankungen. Akt Rheumatol 1993;18:14–18.
MacAdams MR, White RH, Chipps BE. Reduction of serum testosterone levels during chronic glucocorticoid therapy. Ann Intern Med 1986;104:648–651.
Olgaard K, Storm T, van Wowern N, Daugaard H, Egfjord M, Lewin E, et al. Glucocorticoid-induced osteoporosis in the lumbar spine, forearm, and mandible of nephrotic patients: a double-blind study on the high-dose long-term effects of prednisone versus deflazacort. Calcif Tissue Int 1992;50:490–497.
Messina OD, Barreira JC, Zanchetta JR, Maldonado-Cocco JA, Boagado CE, Sebastian ON, et al. Effect of low doses of deflazacort vs prednisone on bone mineral content in premenopausal rheumatoid arthritis. J Rheumatol 1992;19:1520–1526.
Blumsohn A, Herrington K, Hannon RA, Shao P, Eyre DR, Eastell R. The effect of calcium supplementation on the circadian rhythm of bone resorption. J Clin Endocrinol Metab 1994;79:730–735.
van de Voorde M, Dequeker J, Geusens P. Effect of one late evening dose of calcium on bone resorption in postmenopausal women. In: Christiansen C, Overgaard K, editors. Osteoporosis. Copenhagen: Osteopress, 1990:1192–1193.
Reid IR, Ibbertson HK. Calcium supplements in the prevention of steroid-induced osteoporosis. Am J Clin Nutr 1986;44:287–290.
Bijlsma JWJ, Raymakers JA, Mosch C, Hoekstra A, Derksen RH, Baart de la Faille H, et al. Effect of oral calcium and vitamin D on glucocorticoid-induced osteopenia. Clin Exp Rheumatol 1988;6:113–119.
Adams JS, Wahl TO, Luker BP. Effects of hydrochlorothiazide and dietary sodium restriction on calcium metabolism in corticosteroid treated patients. Metabolism 1981;30:217–221.
Boutsen Y, Jamart J, Esselinckx W, Stoffel M, Devogelaer JP. Primary prevention of glucocorticoid-induced osteoporosis with intermittent intravenous pamidronate: a randomized trial. Calcif Tissue Int 1997;61:266–271.
Adachi JD, Bensen WG, Brown J, Hanley T, Hodsman A, Josse R, et al. Intermittent etidronate therapy to prevent corticosteroid-induced osteoporosis. N Engl J Med 1997;337:382–387.
Roux C, Oriente P, Laan R, Hughes RA, Ittner J, Goemaere S, et al. Randomized trial of effect of cyclical etidronate in the prevention of corticosteroid-induced bone loss. J Clin Endocrinol Metab 1998;83:1128–1133.
Saag KG, Emkey R, Schnitzer TJ, Brown JP, Hawkins F, Goemaere S, et al. Alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis. N Engl J Med 1998;339:292–299.
Hooyman JR, Melton LJ III, Nelson AM, O’Fallon WM, Riggs BL. Fractures after rheumatoid arthritis. A population-based study. Arthritis Rheum 1991;34:912–915.
Dequeker J, Heylen H, Burssens A. Spontaneous fractures of pelvis in rheumatoid arthritis. BMJ 1972;I:29:314.
Schneider R, Kaye JJ. Insufficiency and stress fractures of the long bones occurring in patients with rheumatoid arthritis. Radiology 1975;116:595–599.
Young A, Kinsella P, Boland P. Stress fractures of the lower limb in patients with rheumatoid arthritis. J Bone Joint Surg Br 1981;63:239–243.
Reynolds MT. Stress fractures of the tibia in the elderly associated with knee deformity. Proc R Soc Med 1972;65:377–380.
Straaton KV, Lopez-Mendez A, Alarcon GS. Insufficiency fractures of the distal tibia misdiagnosed as cellulitis in three patients with rheumatoid arthritis. Arthritis Rheum 1991;34:912–915.
Semba CP, Mitchell MJ, Sartoris DJ, Resnick D. Multiple stress fractures in the hind-foot in rheumatoid arthritis. J Rheumatol 1989;16:671–676.
Kahanpal S, McLeod RA, Luthra HS. Insufficiency-type stress fractures in rheumatoid arthritis: report of an interesting case and review of the literature. Clin Exp Rheumatol 1986;4:151–154.
Wordsworth BP, Vipond S, Woods CG, Mowat AG. Metabolic bone disease among inpatients with rheumatoid arthritis. Br J Rheumatol 1984;23:251–257.
Maenaut K, Westhovens R, Dequeker J. Methotrexate osteopathy: does it exist? J Rheumatol 1996;23:2156–2159.
Ragab AH, Fresh RS, Vietti TJ. Osteoporotic fractures secondary to methotrexate therapy of acute leukemia in remission. Cancer 1970;25:580–585.
Preston SJ, Diamon T, Scott A, Laurent MR. Methotrexate osteopathy in rheumatic disease. Ann Rheum Dis 1993;52:582–585.
Ansell G, Evans S, Jackson CT, Lewis-Jones S. Cytotoxic drugs for non-neoplastic disease. BMJ 1983;287:762.
Bologna C, Edno L, Anaya J, Canovas F, Vanden Berghe M, Jorgensen C, et al. Methotrexate concentrations in synovial membrane and trabecular and cortical bone in rheumatoid arthritis patients. Arthritis Rheum 1994;37:1770–1773.
Friedlaender GE, Tross RB, Doganis AC, Kirkwood JM, Baron R. Effects of chemother-apeutic agents on bone. J Bone Joint Surg 1984;66:602–607.
May KP, West SG, McDermott MT, Huffer WE. The effect of low-dose methotrexate on bone metabolism and histomorphometry in rats. Arthritis Rheum 1994;37:201–206.
Katz JN, Leboff MS, Wade JP, Brown EM, Liang MH. Effect of methotrexate on bone density and calcium homeostasis in rheumatoid arthritis. Clin Res 1989;37:509A.
Kirwan JR. The effect of glucocorticoids on joint destruction in rheumatoid arthritis. The Arthritis and Rheumatism Council low-dose glucocorticoid study group. N Engl J Med 1995;333:142–146.
Boers M, Verhoeven AC, Markusse HM, van de Laar MAFJ, Westhovens R, van Denderen JC, et al. Randomised comparison of combined step down prednisolone methotrexate and sulphasalazine versus sulphasalazine alone in early rheumatoid arthritis. Lancet 1997;350:309–318.
Sileghem A, Geusens P, Dequeker J. Intranasal calcitonin for the prevention of bone erosion and bone loss in rheumatoid arthritis. Ann Rheum Dis 1992;51:761–764.
Ralston SH, Hacking L, Willocks L, Bruce F, Pitkeathly DA. Clinical, biochemical and radiographic effects of aminohydropropylidene bisphosphonate treatment in rheumatoid arthritis. Ann Rheum Dis 1989;48:396–399.
Bird HA, Hill J, Sitton NG, Dixon JS, Wright V. A clinical and biochemical assessment of etidronate disodium in patients with active rheumatoid arthritis. Clin Rheumatol 1988;7:18–23.
Maccagno A, Di Giorgio E, Roldan EJA, Caballero LE, Perez Lloret A. Double blind radiological assessment of continuous oral pamidronic acid in patients with rheumatoid arthritis. Scand J Rheumatol 1994;23:211–214.
Önsten I, Åkesson K, Besjakov J, Obrant KJ. Migration of the charnley stem in rheumatoid arthritis and osteoarthritis. J Bone Joint Surg Br 1995;77:18–22.
Önsten I, Åkesson K, Obrant KJ. Micromotion of the acetabular component and peri-acetabular bone morphology. Clin Orthop 1995;310:103–110.
Åkesson K, Önsten I, Obrant KJ. Periarticular bone in rheumatoid arthritis versus arthrosis. Acta Orthop Scand 1994;65:135–138.
Wolfe F, Zwillich SH. The long-term outcomes of rheumatoid arthritis. Arthritis Rheum 1998;41:1072–1082.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2000 Springer-Verlag London
About this chapter
Cite this chapter
Dequeker, J., Westhovens, R., Ravelingien, I. (2000). Osteoporosis in Rheumatoid Arthritis. In: Obrant, K. (eds) Management of Fractures in Severely Osteoporotic Bone. Springer, London. https://doi.org/10.1007/978-1-4471-3825-9_36
Download citation
DOI: https://doi.org/10.1007/978-1-4471-3825-9_36
Publisher Name: Springer, London
Print ISBN: 978-1-84996-855-3
Online ISBN: 978-1-4471-3825-9
eBook Packages: Springer Book Archive