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.