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Impaired Bone Physiology in Rheumatoid Arthritis: Can the Wnt Pathway be the Connecting Link Between the Synovium and
Michail I Krikelis1, Dimitra Moschou2, Konstantina Zoupidou3
1Laboratory for the Research of Musculoskeletal System "Th. Garofalidis", Medical School, National and Kapodistrian University of Athens, KAT General Hospital, Athens, Greece.
Introduction And Methods:
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterised by bone loss. A Medline/PubMed search was conducted in September 2025 using the keywords "rheumatoid arthritis" AND "bone loss." The search was restricted to recently published review or systematic review articles (2020-2025). In total, 24 articles were thoroughly reviewed.
Results:
Inflammation-induced accelerated bone resorption both at the systemic level and in juxta-articular bone is typical to rheumatoid arthritis. Bone formation and bone biomechanics are also impaired due to inflammation, prolonged or repeated corticosteroid treatment, and muscle wasting.
Conclusions:
Aberrant bone loss and impaired bone formation are hallmarks of rheumatoid arthritis. The underlying pathophysiological mechanisms differ between early and refractory disease, suggesting a potential central role of the highly conserved Wnt pathway in the bone impairment observed in established RA.
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