A Case of Elderly Rheumatoid Arthritis with Fracture Cascade Triggered by Worsening Disease Activity

Patients with rheumatoid arthritis (RA) have generalized bone loss and deterioration of bone quality, leading to a relatively higher risk of vertebral and non-vertebral fractures. It has been previously reported that patients who cause fragility fractures such as vertebral fractures, had statistically higher scores of RA disease activity, but there are no case reports.

The case described in this report is an elderly woman with RA who was receiving treatment including glucocorticoids. Her state of RA activity had been in remission for a long time, and she was also receiving treatment to prevent osteoporosis. However, the worsening of the disease activity triggered a fracture cascade starting from a vertebral fracture and her activities of daily living deteriorated rapidly.

This report highlights the difficulties in treating osteoporosis and preventing fragility fractures in an elderly patient with RA and the importance of managing RA disease activity.