rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2026-208-213rsp-3918Research ArticleОПИСАНИЕ СЛУЧАЯCASE DESCRIPTIONМетотрексатная остеопатия при ревматоидном артрите: случай из клинической практикиMethotrexate osteopathy in rheumatoid arthritis: A case from clinical practicehttps://orcid.org/0000-0003-0560-3495КозыреваМ. В.KozyrevaM. V.

Козырева Мария Витальевна

115522, Москва, Каширское шоссе, 34а

Maria V. Kozyreva

115522, Moscow, Kashirskoye Highway, 34A

doginya@yandex.ruhttps://orcid.org/0000-0003-1505-7563СухининаА. В.SukhininaA. V.

115522, Москва, Каширское шоссе, 34а

Anastasiia V. Sukhinina

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-1084-3920КудинскийД. М.KudinskyD. M.

115522, Москва, Каширское шоссе, 34а

Danil M. Kudinsky

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0002-7661-3124ФеклистовА. Ю.FeklistovA. Yu.

115522, Москва, Каширское шоссе, 34а

Alexey Yu. Feklistov

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-0394-9249КоротковаТ. А.KorotkovaT. A.

115522, Москва, Каширское шоссе, 34а

Tatiana A. Korotkova

115522, Moscow, Kashirskoye Highway, 34A

https://orcid.org/0000-0003-4739-4302ТоропцоваН. В.ToroptsovaN. V.

115522, Москва, Каширское шоссе, 34а

Natalia V. Toroptsova

115522, Moscow, Kashirskoye Highway, 34A

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202602052026642208213Copyright © Козырева М.В., Сухинина А.В., Кудинский Д.М., Феклистов А.Ю., Короткова Т.А., Торопцова Н.В., 20262026Козырева М.В., Сухинина А.В., Кудинский Д.М., Феклистов А.Ю., Короткова Т.А., Торопцова Н.В.Kozyreva M.V., Sukhinina A.V., Kudinsky D.M., Feklistov A.Y., Korotkova T.A., Toroptsova N.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3918

Метотрексат (МТ) – один из наиболее применяемых при лечении ревматических заболеваний (РЗ) базисных противовоспалительных препаратов. Сегодня он назначается ревматологическим пациентам в дозах, не превышающих 25 мг в неделю. В ходе использования в клинической практике появились данные о возможном побочном действии МТ на костную ткань – связанной с его длительным приемом остеопатии, которая при РЗ встречается редко и характеризуется наличием трех признаков: боли в костях нижних конечностей при нагрузке, атравматичных переломов, локализующихся в различных костях нижних конечностей, и остеопороза, выявляемого при рентгенографии костей.

В статье приводится описание случая остеопатии на фоне длительного лечения МТ у пациентки в постменопаузе с РА и остеопорозом, у которой возникли множественные атравматичные стрессовые переломы в дистальных отделах бедренных, проксимальных и большеберцовых костей, а также в таранной кости левой стопы.

Methotrexate (МТX) is one of the most widely used medication as a basic anti-inflammatory therapy in the treatment of rheumatic diseases (RD). It is prescribed to rheumatological patients in doses not exceeding 25 mg per week. As it was used in clinical practice, data appeared on a possible side effect on bone tissue – osteopathy associated with its long-term use, which is rare in patients with RD. Methotrexate osteopathy is characterized by the presence of three signs: bone pain in weight-bearing limbs; atraumatic fractures localized in various bones of the lower extremities; the presence of osteoporosis on the X-ray image.

The article describes a case of osteopathy after long-term treatment with МТX in a postmenopausal patient with RA and osteoporosis who had multiple atraumatic stress fractures of both distal femurs, proximal and distal part of both tibias, as well as the talus of the left foot.

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The authors declare that there are no conflicts of interest present.