Brucellosis is a common global zoonotic disease caused by Brucella, which has a variety of clinical manifestations. Fever, sweating and musculoskeletal pains appear in partial brucellosis patients. The most common complication of brucellosis is osteoarthritis, including spondylitis, sacroiliitis, and peripheral arthritis such as osteomyelitis, bursitis, and tenosynovitis. The spine and sacroiliac are the most frequent affected sites of brucellosis osteoarthritis; however, the reports of peripheral arthritis such as osteomyelitis, bursitis, and tenosynovitis are low. Early and proper treatment is vital for patients with brucellosis osteoarthritis. The therapy of drugs and surgery are two current options for treatment of brucellosis osteoarthritis. In this review, clinical manifestations and treatments of brucellosis osteoarthritis are discussed in detail, which are helpful to deepen clinicians' knowledge in brucellosis.

Brucellosis is a common bacterial zoonotic disease that affects a variety of organs and tissues and causes a variety of clinical manifestations. Bone and joint are the most frequently involved parts, among which sacroiliac arthritis, spondylitis and peripheral arthritis are the most common osteoarticular disease. Brucella induces bone damage by affecting various cells of the skeletal system and the immune system, Brucella increases the expression of nuclear factor kappa B receptor activating factor ligand (RANKL), tumor necrosis factor (TNF)-α and interleukin (IL)-17 in osteoclasts and osteocytes, enhances the activity of osteoclasts. Brucella can proliferate in osteoblasts and osteocytes, induce apoptosis of osteoblasts and osteocytes, and inhibit the deposition of mineral and organic matrix in osteoblasts. After Brucella infection, inflammatory cells such as monocyte macrophages, neutrophils, T cells and B cells also participate in the inflammatory response, these inflammatory cells and bone system secrete more pro-inflammatory cytokines, chemokines and matrix metalloproteinases (MMPs), which enhance the inflammatory response and promote the degradation of extracellular matrix. Finally, the bone homeostasis is broken and the bone injury is aggravated. With the development of research on the molecular mechanism of Brucella osteoarthropathy, more and more people will understand the pathogenesis of chronic osteoarthropathy caused by Brucella.