PT  - JOURNAL ARTICLE
AU  - Gillian E. Fitzgerald
AU  - Finbar D. O’Shea
TI  - The Fascinating Paradox of Osteoporosis in Axial Spondyloarthropathy
AID  - 10.3899/jrheum.170051
DP  - 2017 Dec 01
TA  - The Journal of Rheumatology
PG  - 1767--1776
VI  - 44
IP  - 12
4099  - http://www.jrheum.org/content/44/12/1767.short
4100  - http://www.jrheum.org/content/44/12/1767.full
SO  - J Rheumatol2017 Dec 01; 44
AB  - Low bone mineral density (BMD) is a recognized feature of axial spondyloarthropathy (axSpA). However, the osteoproliferation inherent in axSpA can make traditional dual-energy x-ray absorptiometry assessment inaccurate, particularly in structurally advanced disease. As a result, much about osteoporosis in axSpA is unknown. There is a wide variation in prevalence figures for low BMD in the literature. There is also no consensus regarding risk factors for developing low BMD in axSpA. It is accepted that there is an excess of vertebral fractures in patients with axSpA, but the role of low BMD in contributing to this risk is virtually unknown. This article provides a comprehensive review of the current knowledge regarding low BMD in axSpA. It highlights our current BMD measurement techniques along with their potential pitfalls, and discusses the significance of BMD in vertebral fractures. It also identifies gaps in our knowledge and makes recommendations for future research.