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Osteocyte viability with glucocorticoid treatment: relation to histomorphometry
P N Sambrook1, D R Hughes, A E Nelson
1Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Australia. sambrook@med.usyd.edu.au
Background:
Glucocorticoid induced osteoporosis is a common clinical problem.
Objective:
To determine the pathophysiology of glucocorticoid induced osteoarthritis at the organ level.
Methods:
Iliac crest biopsy specimens were obtained from nine patients receiving prednisone treatment for rheumatoid arthritis. Osteocyte viability and histomorphometric indices were assessed.
Results:
Compared with controls, glucocorticoid treated subjects had reduced trabecular thickness and increased erosion. The number of viable osteocytes was significantly decreased in glucocorticoid treated patients compared with controls.
Conclusion:
The impaired bone formation, increased erosion and, importantly, loss of viable osteocytes are all likely to contribute to the increased risk of fracture in these patients.
