[Secondary osteoporosis. Fractures in patients with rheumatoid arthritis]

Patients with rheumatoid arthritis (RA) are at increased risk for developing osteoporosis and fractures compared to controls. This risk is further increased since a majority of patients with RA also receive concomitant corticosteroids, which have been shown to induce osteoporosis and increase the risk of fractures. Currently, low bone mineral density, older age, corticosteroid use, history of prior fracture, and high disease activity are recognized as important risk factors for fractures in patients with RA. Recently, we reported results from a prospective observational cohort study that showed that high health assessment questionnaire (HAQ) disability scores and history of prior orthopedic surgery for RA are also significant risk factors for this patient population developing fractures. This article reviews the epidemiology and associated risk factors with the development of fractures in patients with RA.