Rheumatic manifestations of Parkinson’s disease: an overview

Objective: Parkinson's disease is the second most common neurodegenerative disorder after Alzheimer's disease. It can be responsible for several rheumatological manifestations. This article aimed to review and summarize current knowledge on musculoskeletal diseases associated with Parkinson's disease and their management. Methods: We conducted a narrative review of musculoskeletal features associated with Parkinson's disease. Results: Rheumatological manifestations of Parkinson's disease include postural disorders (antecollis, cervical kyphosis, cervical positive sagittal malalignment, camptocormia, Pisa syndrome, scoliosis), bone disorders (osteoporosis, bone fractures), and joint disorders (frozen shoulder, hand, and foot deformities). Rheumatological manifestations lead to physical disability, long-term pain, and impaired quality of life. However, the management of these manifestations is not yet codified. It can associate botulinum toxin, thoraco-pelvic anterior distraction, orthosis, orthopedic surgical correction, pallidotomy, or deep brain stimulation in patients with camptocormia. Therapeutic management of osteoporosis includes calcium and vitamin D intake and bisphosphonates. Conclusion: Rheumatological manifestations are common in Parkinson’s disease. Optimal care of patients with Parkinson’s disease should include attention to management of postural, bone, and joint disorders since it remains a major cause of functional impairment and disability.