Key Points ■ Sickle cell disease (SCD) and thalassemia are the main hemoglobinopathies associated with rheumatic manifestations. Both are genetic inherited diseases. ■ Sickle cell disease results from structurally abnormal hemoglobin, whilst thalassemia is due to decreased synthesis of structurally…
Key Points Hemophilia ■ Hemophilia is an X-linked inherited bleeding disorder caused by a deficiency of factor VIII (hemophilia A) or IX (hemophilia B). ■ Bleeding occurs either spontaneously or with minor trauma. Recurrent hemarthroses can lead to progressive arthritis,…
Key Points ■ Musculoskeletal abnormalities occur commonly in association with endocrine disease. ■ Glandular dysfunction involving the pituitary, pancreas, thyroid, parathyroid, or adrenals may be manifested as rheumatologic disorders. ■ Classic, nonspecific, or unusual rheumatic abnormalities may occur. ■ Muscle…
Key Points ■ Osteonecrosis results from cell death in components of bone: hematopoietic fat marrow and mineralized tissue. ■ Osteonecrosis in its prototypical form results from impairment of the blood supply to the femoral head; consequently, the terms avascular necrosis…
Key Points ■ Neuropathic arthropathy is a progressive, destructive joint disease associated with sensory loss. ■ It is characterized by relative lack of pain resulting from sensory neuropathy and by atrophic changes on plain radiography. ■ Bony swelling and soft…
Key Points ■ This chronic, age-related condition is characterized by new bone growth, especially at entheses. ■ Radiologic findings are characteristic but may be confused with those of spondyloarthritis. ■ Few symptoms are related to diagnostic changes in the thoracic…
Key Points ■ Paget disease of bone is a focal disorder of bone remodeling characterized by accelerated bone resorption coupled with formation that results in bony enlargement and deformity. ■ The disease may occur in one or more bones; has…
Key Points ■ Osteomalacia is caused by a defect in the mineralization of osteoid laid down by mature osteoblasts. The most common causes of osteomalacia and rickets are vitamin D deficiency and calcium deficiency. Any acquired or inherited disorder that…
Key Points ■ Glucocorticoids are commonly prescribed, and even chronic low doses can have deleterious effect on bone. ■ Fracture risk is correlated to the dose and duration of glucocorticoid exposure. ■ Multiple classes of medications have been shown to…
Key Points ■ It is estimated that more than 9% of adults older than the age of 50 years have osteoporosis at either the femoral neck or lumbar spine. ■ In Canada, the lifetime risk for hip fracture is estimated…