Source:Merkel PA. Rheumatic disease and cystic fibrosis.
Arthritis Rheum.

There are a number of musculoskeletal disorders that afflict patients with cystic fibrosis (CF). These conditions result from the multiple immunologic and inflammatory abnormalities present in these patients. They include the following:

This is a superb review article that summarizes the work of multiple authors1–,4 and updates the most recent review by Rush et al.5 Of note, the author of this review left rickets off the list. It is quite possible that a young child with steatorrhea secondary to CF could develop rickets from Vitamin D deficiency. When a child with a multifaceted chronic illness like CF presents with a painful and/or swollen joint, all diagnostic possibilities should be carefully considered.

As the molecular pathophysiology of CF becomes clearer, the mechanisms underlying the immunologic relationships between the GI, pulmonary, and joint diseases may become better understood. In the meantime, this article encapsulates what is known clinically about the joint problems associated with CF and, in so doing, enables us to be more aggressive in the diagnosis and treatment of the rheumatologic problems associated with this chronic disease.

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