Osteocyte viability with glucocorticoid treatment: relation to histomorphometry.

BACKGROUND Glucocorticoid induced osteoporosis is a common clinical problem. OBJECTIVE To determine the pathophysiology of glucocorticoid induced osteoarthritis at the organ level. METHODS Iliac crest biopsy specimens were obtained from nine patients receiving prednisone treatment for rheumatoid arthritis. Osteocyte viability and histomorphometric indices were assessed. RESULTS Compared with controls, glucocorticoid treated subjects had reduced trabecular thickness and increased erosion. The number of viable osteocytes was significantly decreased in glucocorticoid treated patients compared with controls. CONCLUSION The impaired bone formation, increased erosion and, importantly, loss of viable osteocytes are all likely to contribute to the increased risk of fracture in these patients.