59. Inflammation-Induced Bone Loss in the Rheumatic Diseases

  1. Clifford J. Rosen MD
  1. Steven R. Goldring

Published Online: 19 JUL 2013

DOI: 10.1002/9781118453926.ch59

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

Goldring, S. R. (2013) Inflammation-Induced Bone Loss in the Rheumatic Diseases, 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.ch59

Publication History

  1. Published Online: 19 JUL 2013

ISBN Information

Print ISBN: 9781118453889

Online ISBN: 9781118453926

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Keywords:

  • ankylosing spondylitis (AS);
  • inflammation-induced bone loss;
  • rheumatoid arthritis (RA);
  • systemic lupus erythematosus (SLE)

Summary

This chapter focuses on rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and the seronegative spondyloarthropathies, which include ankylosing spondylitis (AS), reactive arthritis, the arthritis of inflammatory bowel disease, juvenile-onset spondyloarthropathy, and psoriatic arthritis. Four major forms of pathologic skeletal remodeling can be observed in RA, including focal marginal articular erosions, subchondral bone loss, periarticular osteopenia, and systemic osteoporosis. AS is characterized by inflammation in the entheses, as well as the synovial lining of peripheral joints. Examination of the synovial lesion reveals many of the same features as the RA synovium, including synovial lining hyperplasia, lymphocytic infiltration and pannus formation. In contrast to the pattern of articular bone remodeling in RA, in patients with AS, the inflammatory process may be accompanied by evidence of increased bone formation. SLE, similar to RA, is a systemic inflammatory disease, which, in addition to targeting joint structures, may be associated with widespread extra-articular organ damage.