Review Article

Bone Disease in Autoimmune Rheumatic Diseases Among Young Adults: A Comprehensive Review

Athanasia Tatsi¹, Symeon Tournis²

1. Postgraduate Program “Metabolic Bone Diseases”, National and Kapodistrian University of Athens, Medical School, Athens, Greece
2. Laboratory for the Research of the Musculoskeletal System “Th. Garofalidis”, National and Kapodistrian University of Athens, Medical School, Athens, Greece

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Keywords: Avascular necrosis, Autoimmune rheumatic diseases, Osteoporosis, Glucocorticoids

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Abstract

Autoimmune rheumatic diseases (ARDs) encompass a diverse array of conditions with varied clinical manifestations affecting multiple body systems. Among young patients with ARD, the most common bone disorders are avascular necrosis (AVN) and osteoporosis. ARDs and glucocorticoid use pose major risk factors for AVN and osteoporosis in this population. Unexplained hip pain should raise suspicion of AVN, warranting further investigation, such as MRI. While traditionally associated with older individuals, osteoporosis should not be overlooked in young adults with ARDs. Assessing fracture risk and implementing appropriate management strategies are crucial. Early recognition and tailored treatment are essential for preserving quality of life. ARDs and glucocorticoid use increase osteoporosis risk. Premenopausal women with conditions like rheumatoid arthritis may experience a 17.1% decrease in femoral neck BMD. Similarly, patients with spondyloarthritis exhibit high osteoporosis rates. Diagnosing and managing osteoporosis in young adults remain challenging, highlighting the importance of fracture prevention. Guidelines offer recommendations for preventing, monitoring, and treating glucocorticoid-induced osteoporosis. Considering prevention, early recognition, and appropriate treatment are vital during the clinical evaluation of young adults. Addressing these aspects improves outcomes and mitigates skeletal comorbidity in ARDs.

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