58. Glucocorticoid-Induced Bone Disease

  1. Clifford J. Rosen MD
  1. Robert S. Weinstein

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch58

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition

How to Cite

Weinstein, R. S. (2013) Glucocorticoid-Induced Bone Disease, in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition (ed C. J. Rosen), John Wiley & Sons, Inc., Ames, USA. doi: 10.1002/9781118453926.ch58

Publication History

  1. Published Online: 19 JUL 2013
  2. Published Print: 19 AUG 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • fractures;
  • glucocorticoid-induced bone disease;
  • osteonecrosis

Summary

Glucocorticoid-induced osteoporosis (GIO) is the second most common form of osteoporosis and is the most common iatrogenic form of the disease. Fractures may occur in 30% to 50% of patients receiving chronic glucocorticoid therapy and many are asymptomatic, possibly due to glucocorticoid-induced analgesia. In addition to fractures, glucocorticoid administration is the most common cause of nontraumatic osteonecrosis. The absence of severe underlying disease or the presence of youth does not convey protection from glucocorticoid-induced bone disease. A devastating accompaniment of long-term glucocorticoid therapy is osteonecrosis (also known as aseptic necrosis, avascular necrosis, or ischemic necrosis). Under some circumstances (vasculitis, rheumatoid arthritis, lupus, status asthmaticus, inflammatory bowel disease), high-dose glucocorticoid therapy is an emergency; the clinician always hopes that the course of treatment will be brief, and, therefore, does not address the complications of these drugs.