Glucocorticoid-induced osteoporosis

Glucocorticoid-induced osteoporosis is a skeletal condition in which treatment with corticosteroid medicines weakens bone by increasing its breakdown and reducing new bone formation, so that fractures occur after minor falls. It affects people taking glucocorticoids for rheumatoid arthritis, lupus, asthma, inflammatory bowel disease, skin disease or after transplantation, and oral or injected forms carry the greatest risk. Higher doses raise the risk, though low doses can also cause it over time, as can older age, menopause, smoking, heavy alcohol use, low calcium and vitamin D intake, family history and earlier fragility fractures. Bone loss is rapid early in treatment, and weakened bone with a raised fracture risk is the main feature, with fractures bringing pain and disability. A bone density scan detects it. Management uses the lowest effective steroid dose, calcium, vitamin D, weight-bearing exercise, and bone-protective bisphosphonates or other agents for higher-risk patients.

Seek urgent care for a fracture after a minor fall, a hot swollen joint with fever, or sudden severe back pain. See a doctor for joint pain and stiffness lasting more than six weeks, loss of height, or if you have risk factors for weak bones and have never had a bone-density assessment. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.