The influence of sex in arthritis: is cartilage an overlooked factor?

Sex emerges as a predominant risk and prognostic factor from epidemiological studies in a variety of rheumatic diseases. Investigations into the underlying mechanisms stress sex related differences in immune and inflammatory responses. Cartilage destruction is an essential feature of most arthropathies and plays an essential role in the symptomatology and progression of arthritis. Based on published evidence and recent experimental observations, we explore the possibility that sex differences in articular cartilage may be an important, though unrecognized, factor in the effects of sex and related hormones in the progression of articular disease.