Summary: Osteorheumatology: A New Discipline?
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Read the summary and the most important questions on OsteoRheumatology: a new discipline?
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1 Introduction
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What is the basic idea underlying OsteoRheumatology?
The importance of the crosstalk between inflammation, cartilage and subchondral bone in disabling conditions like OA and RA. -
2 Bone involvement in OA
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What is the hallmark of osteoarthritis?
Destruction of cartilage -
What are the keywords in osteoarthritis?
- cartilage
- subchondral bone
- synovial membrane
- low-grade inflammation
- estrogen-deficiency
- wear
- local
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3 The role of subchondral bone in OA
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What are the typical skeletal changes in OA?
- increased cortical plate thickness
- flattening and deformation of the articular contour
- bone marrow lesions
- decreased subchondral trabecular bone mass
- tidemark duplication
- osteophyte formation
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Where is subchondral bone located?
Below the cartilage of the joints and has same properties as the epihyseal plate (growth plate) -
Which two phenotypes can be distinghuised as a result of increased subchondral bone remodeling?
- Sclerosis
- Osteoporosis
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How is a sclerotic phenotype induced?
By mechanically overloading the subchondral bone on the osteochondral junction. -
How can a subchondral osteoporotic phenotype be induced?
- estrogen deficiency or menopause
- stress shielding
- synovial inflammation
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What can be said about the quality of the subchondral bone in OA?
The quality is low because the bone is hypomineralized (has probably to do with a collagen type that has low affinity for Calcium). -
What is said about the osteoblast cytokine production?
It has increased production of both bone stimulating and bone degradation signaling cytokines.
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