Male Osteoporosis with Vertebral Fractures? Look for Ankylosing Spondylitis! A Report of 10 Cases

MICHEL LAROCHE, SLIM LASSOUED, THIERRY BILLEY, JACQUES BERNARD, and BERNARD MAZIÈRES

ABSTRACT.

Objective. Several authors have described the association of ankylosing spondylitis (AS) and osteoporosis. Usually vertebral fractures complicate severe AS.

Methods. We report a series of 10 men in whom benign spondyloarthropathy was discovered during etiological investigation for osteoporosis. Eight patients had B27+ AS and 2 had psoriatic arthritis with axial involvement. The mean number of vertebral fractures was 1.5. No patient had an appendicular fracture.

Results. Phosphorus and calcium levels and measurements of 25OHD3, parathyroid hormone, osteocalcin, and serum CTX were in the normal range. The decrease in bone mineral density was greater in the spine (mean T-score at L2–L4 –2.95, mean total hip T-score –1.67).

Conclusion. Osteoporosis with fractures may reveal benign spondyloarthropathy whose clinical expression is sometimes incomplete. Our findings demonstrate that osteoporosis is not always correlated with the severity of AS. (First Release Oct 1 2007; J Rheumatol 2007;34:2271-2)

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Key Indexing Terms:

OSTEOPOROSIS
MEN
VERTEBRAL FRACTURE
ANKYLOSING SPONDYLITIS

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From the Service de Rhumatologie, CHU Rangueil, and Service de Rhumatologie, CHG Cahors, Toulouse, France.

M. Laroche, MD; J. Bernard, MD; B. Mazières, MD, Service de Rhumatologie, CHU Rangueil; S. Lassoued, MD; T. Billey, MD, Service de Rhumatologie, CHG Cahors.

Address reprint requests to Prof. M. Laroche, Service de Rhumatologie, CHU Rangueil, 1 avenue J. Poulhès, 31059 Toulouse Cedex 9, France. E-mail: laroche.m@chu-toulouse.fr

Accepted for publication July 12, 2007.

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