Matteucci B M
University of Pennsylvania, Philadelphia, USA.
Curr Opin Rheumatol. 1995 Jul;7(4):356-8. doi: 10.1097/00002281-199507000-00016.
Many metabolic and endocrine disorders have effects on the musculoskeletal system, either due to primary changes in bone and collagen or resulting in secondary arthritic and bone changes. Disorders of ossification include heterotopic ossification, diffuse idiopathic skeletal hyperostosis (DISH), and the spondyloarthropathies. The early stages of heterotopic ossification have been analyzed using immunohistochemical techniques to trace the distribution of noncollagenous proteins. Several radiographic features of DISH and ankylosing spondylitis were discussed, including rib hyperostosis and syndesmophytes. Hypertrophic osteoarthropathy with associated arthritis was described in seven patients with hepatic failure and transplantation. Remarkable improvement in arthritis followed transplantation. The inverse relationship between osteoarthritis and osteoporosis continues to be studied, and it has been hypothesized that genetics play a major role in determining the rate of bone turnover, resulting in, for example, "bone formers." Both growth hormone excess and deficiency lead to changes in the incidence of osteoarthritis. Finally, one study documented the improved outcome in joint replacements in hemophiliac patients.
许多代谢和内分泌紊乱会对肌肉骨骼系统产生影响，这要么是由于骨骼和胶原蛋白的原发性变化，要么是导致继发性关节炎和骨骼变化。骨化紊乱包括异位骨化、弥漫性特发性骨肥厚（DISH）和脊柱关节病。已使用免疫组织化学技术分析异位骨化的早期阶段，以追踪非胶原蛋白的分布。讨论了DISH和强直性脊柱炎的一些放射学特征，包括肋骨骨肥厚和韧带骨赘。描述了7例肝功能衰竭和肝移植患者伴有关节炎的肥厚性骨关节病。肝移植后关节炎有显著改善。骨关节炎与骨质疏松症之间的反比关系仍在研究中，据推测，遗传学在决定骨转换率方面起主要作用，例如导致“骨形成者”。生长激素过多和过少都会导致骨关节炎发病率的变化。最后，一项研究记录了血友病患者关节置换术后的改善结果。
