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Methotrexate osteopathy in rheumatic disease.
OBJECTIVE: To determine whether two adults with stress fractures receiving low weekly doses of methotrexate had methotrexate osteopathy.
CASE REPORTS: Two adult patients developed features consistent with methotrexate osteopathy while receiving low weekly doses of methotrexate.
METHODS: Iliac crest biopsy samples were taken and bone histomorphometry carried out.
RESULTS: Symptoms resolved when the methotrexate was discontinued. Bone histology showed changes consistent with osteoblast inhibition by methotrexate.
CONCLUSIONS: When given in low doses for prolonged periods, methotrexate may have adverse effects on bone, particularly in post-menopausal women.
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