title: Fragility Fractures in Patients with Psoriatic Arthritis.
abstract: Psoriatic arthritis (PsA) can have peculiar effects on bone, including mechanisms of bone loss such as erosions, but also of bone formation, such as ankylosis or periostitis. The aim of the present study was to describe the prevalence of fractures in patients with PsA as compared to healthy controls and to investigate determinants of fractures among cases. For both cases and controls, radiographs were read to identify vertebral fractures (VF), and the presence of femoral neck or other nonvertebral fractures was obtained from patients' medical history. The prevalence of fragility fractures on radiographic readings did not differ between cases and controls. The number of subjects showing a VF was 33 (36%) among PsA patients and 36 (36%) among controls, with a prevalence of severe VF of 8% among cases and 4% among controls. Controlling for covariates in a logistic model, the only variables showing a significant correlation with the presence of nonvertebral fractures (NVF) were disease duration (p=0.02), age (p=0.03), and bone mineral density at femoral neck (inverse correlation, p=0.04). Fractures should be carefully considered when evaluating the global picture of the patient with PsA for their contribution to the "fragility" profile.
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II. delpuent@unina.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Puente
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Antonella
authors.initials: A
authors.lastname: Esposito
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Luisa
authors.initials: L
authors.lastname: Costa
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Carla
authors.initials: C
authors.lastname: Benigno
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Aurora
authors.initials: A
authors.lastname: Del Puente
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Francesca
authors.initials: F
authors.lastname: Foglia
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Oriente
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Paolo
authors.initials: P
authors.lastname: Bottiglieri
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Francesco
authors.initials: F
authors.lastname: Caso
authors.affiliation: From the Rheumatology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples; and the Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua, Padua, Italy.A. Del Puente, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Esposito, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; L. Costa, MD, Assistant Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; C. Benigno, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Del Puente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Foglia, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; A. Oriente, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; P. Bottiglieri, MD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II; F. Caso, MD, PhD, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II and Rheumatology Unit, Department of Clinical Medicine, DIMED, University of Padua; R. Scarpa, MD, Associate Professor, Rheumatology Research Unit, Department of Clinical Medicine and Surgery, University Federico II.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scarpa
mesh_terms: D000367:Age Factors; D000368:Aged; D015535:Arthritis, Psoriatic / Q000175:diagnosis / Q000453:epidemiology*; D015519:Bone Density; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging / Q000453:epidemiology*; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013997:Time Factors
keywords: EPIDEMIOLOGY; FRACTURES; OSTEOPOROSIS; PSORIATIC ARTHRITIS