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Musculoskeletal Findings in Behcet's Disease

DOI: 10.1155/2012/653806

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Abstract:

Behcet's disease is a multisystem disease characterized by recurrent oral and genital ulcers, relapsing uveitis, mucocutaneous, articular, gastrointestinal, neurologic, and vascular manifestations. Rheumatologic manifestations may also occur in Behcet's disease, and arthritis and arthralgia are the most common musculoskeletal findings followed by enthesopathy, avascular necrosis, myalgia, and myositis. Although the main pathology of Behcet's disease has been known to be the underlying vasculitis, the etiology and exact pathogenesis of the disease are still unclear. Musculoskeletal findings of Behcet's disease, the relationship between Behcet's disease and spondyloarthropathy disease complex, and the status of bone metabolism in patients with Behcet's disease were discussed in this paper. 1. Introduction Behcet’s disease (BD) is a chronic and recurrent multisystemic disorder, mainly characterized by oral and genital aphthous ulcers, skin lesions, and uveitis, occasionally resulting from inflammation in central nervous and gastrointestinal system, lungs, kidneys, and joints [1]. Additionally, BD is described as a systemic, vasculitic disorder in which both arteries and veins of any kind of organ may involve [2]. The disease may be distributed worldwide, but it is more prevalent in Asian and Mediterranean regions [3]. The etiology and pathogenesis of BD still remain obscure. However, both genetic and environmental factors, such as microbial pathogens, have been proposed to initiate a congenital and/or acquired immune dysfunction that cause development of the clinical manifestations of the disease [4]. Musculoskeletal involvement in BD is one of the most frequent findings among the clinical manifestations. Table 1 summarizes the musculoskeletal findings of BD, found in the medical literature. Arthritis and arthralgia are the most common musculoskeletal findings of the disease [5]. Although the frequency of the arthritis has been increasing, it has not been yet included in any International Study Group (ISG) Criteria of BD [6]. Furthermore, it was also claimed that the disease could be classified into the spondyloarthropathy (SpA) complex, because of the presence of sacroiliitis in BD and the clinical overlap between BD and some disease of the SpA complex [7]. On the other hand, the chronicity and factors involved in inflammatory process of the disease and the drugs used for the treatment of BD might have negative effects on bone remodeling, consequently resulting in osteoporosis in BD [8]. Table 1: Rheumatologic findings reported in medical literature. In

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