Methotrexate osteopathy in rheumatic disease.
OBJECTIVE
To determine whether two adults with stress fractures receiving low weekly doses of methotrexate had methotrexate osteopathy.


METHODS
Two adult patients developed features consistent with methotrexate osteopathy while receiving low weekly doses of methotrexate.


METHODS
Iliac crest biopsy samples were taken and bone histomorphometry carried out.


RESULTS
Symptoms resolved when the methotrexate was discontinued. Bone histology showed changes consistent with osteoblast inhibition by methotrexate.


CONCLUSIONS
When given in low doses for prolonged periods, methotrexate may have adverse effects on bone, particularly in post-menopausal women.
Preston
S J
SJ
Department of Rheumatology, Royal North Shore Hospital, St Leonards, Australia.
Diamond
T
T
Scott
A
A
Laurent
M R
MR
D000368:Aged; D001706:Biopsy; D001847:Bone Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D001842:Bone and Bones / Q000473:pathology; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects*; D008875:Middle Aged; D010006:Osteoblasts; D011859:Radiography; D012216:Rheumatic Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology
D008727:Methotrexate