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NIH Almanac - Organization

Contents
About the Almanac
Historical Data
Organization
Appropriations
Staff
Major NIH Lectures
Nobel Laureates
Past Issues
NIAMS logo   National Institute of Arthritis and Musculoskeletal and Skin Diseases
Mission | Important Events | Legislative Chronology | Director | Programs

Until May 19, 1972, the National Institute of Arthritis and Metabolic Diseases; until June 23, 1981, the National Institute of Arthritis, Metabolism, and Digestive Diseases; until April 8, 1986, the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases.

Mission

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) was established in 1986. The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases.

The Institute also conducts and supports basic research on the normal structure and function of joints, muscles, bones, and skin. Basic research involves a wide variety of scientific disciplines, including immunology, genetics, molecular biology, structural biology, biochemistry, physiology, virology, and pharmacology. Clinical research includes rheumatology, orthopaedics, dermatology, metabolic bone diseases, heritable disorders of bone and cartilage, inherited and inflammatory muscle diseases, and sports and rehabilitation medicine.

Important Events in NIAMS History

November 20, 1985 – The Health Research Extension Act of 1985 (P.L. 99-158) authorized the establishment of the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

April 8, 1986 – NIAMS was established.

February 18, 1987 – The first meeting of the National Arthritis and Musculoskeletal and Skin Diseases Advisory Council was held.

April 15, 1996 – NIAMS held a 10th anniversary symposium: "Progress and Promise in Chronic Disease."

NIAMS Legislative Chronology

August 1950 – An arthritis program was established within the National Institute of Arthritis and Metabolic Diseases under P.L. 81-692.

May 1972 – The Institute was renamed the National Institute of Arthritis, Metabolism and Digestive Diseases, P.L. 92-305.

1973 – Senator Alan Cranston introduced legislation that would eventually lead to the National Arthritis Act. Companion legislation was introduced in the House by Congressman Paul Rogers.

January 1975 – The National Arthritis Act (P.L. 93-640) established the National Commission on Arthritis and Related Musculoskeletal Diseases to study the problem of arthritis in depth and to develop an arthritis plan. The act also established the position of associate director for arthritis and related musculoskeletal diseases and authorized an interagency arthritis coordinating committee, community demonstration project grants, an arthritis data bank, an information clearinghouse, and comprehensive centers for research diagnosis, treatment, rehabilitation, and education.

April 1976 – After a year of study and public hearings, the commission issued a comprehensive plan aimed at diminishing the physical, economic, and psychosocial effects of arthritis and musculoskeletal diseases. It laid the groundwork for a national program encompassing research, research training, education, and patient care.

October 1976 – P.L. 94-562, the Arthritis, Diabetes, and Digestive Diseases Amendments of 1976, established the National Arthritis Advisory Board to review and evaluate the implementation of the Arthritis Plan, prepared in response to the National Arthritis Act (P.L. 93-640).

December 1980 – P.L. 96-538 changed the name of the Institute to the National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases.

1982 – The Department conferred bureau status on the Institute, resulting in creation of the Division of Arthritis, Musculoskeletal, and Skin Diseases and the appointment of a division director.

November 1985 – The Health Research Extension Act of 1985, P.L. 99-158, established the National Institute of Arthritis and Musculoskeletal and Skin Diseases to bring increased emphasis to research on these disorders. The legislation provided for the development of a plan for a national arthritis and musculoskeletal diseases program, and establishment of two interagency coordinating committees, one on arthritis and musculoskeletal diseases and one on skin diseases. It also expanded the activities of the National Arthritis Advisory Board to include musculoskeletal and skin diseases.

September 1993 – The NIH Revitalization Act of 1993 (P.L. 103-43) called on NIAMS to establish "an information clearinghouse on osteoporosis and related bone disorders to facilitate and enhance knowledge and understanding on the part of health professionals, patients, and the public through the effective dissemination of information."

October 2000 – The Children's Health Act of 2000 (P.L. 106-310) called on NIAMS to expand and intensify research programs on juvenile arthritis and related conditions, in coordination with other NIH Institutes and the Arthritis and Musculoskeletal Diseases Interagency Coordinating Committee. Further language stipulated that the Institute's current information clearinghouse include resources on juvenile arthritis and associated conditions.

November 2000 – The Lupus Research and Care Amendments of 2000, which passed as part of the Public Health Improvement Act (P.L. 106-505), required NIAMS to expand and intensify research and related activities regarding lupus, and to coordinate such efforts with other NIH Institutes, as appropriate. Among other provisions, the bill called for information and education programs for health professionals and the public.

December 2001 – The Muscular Dystrophy Community Assistance, Research and Education Amendments of 2001, or the MD-CARE Act (P.L. 107-84), called on several components of NIH, including NIAMS, to enhance research on muscular dystrophy, including establishing Centers of Excellence.

February 2003 -  The Office of the Secretary, Department of Health and Human Services (DHHS), was called on to establish a Federal working group on lupus for the purpose of exchanging information and coordinating Federal efforts regarding lupus research and education initiatives (P.L. 108-7, Omnibus Appropriations Act for FY 2003).  The NIAMS, as the lead institute at the NIH for lupus research, was asked to lead this Federal working group.  The group is comprised of representatives from all relevant DHHS agencies and other Federal departments having an interest in lupus.

Biographical Sketch of NIAMS Director Stephen I. Katz, M.D., Ph.D.

Dr. Katz grew up in the Washington, DC and Bethesda, MD areas. He earned a B.A. degree cum laude in history from the University of Maryland, College Park; an M.D. degree cum laude from Tulane University Medical School, New Orleans, LA; and a Ph.D. degree in immunology from the University of London, England. He completed a medical internship at Los Angeles County Hospital, CA; a residency in dermatology at the University of Miami School of Medicine, FL; military service at Walter Reed General Hospital in Washington, DC; and postdoctoral work at the Royal College of Surgeons of England.

In 1974 he joined the National Institutes of Health (NIH) as a senior investigator in the Dermatology Branch of the National Cancer Institute (NCI), becoming acting chief in 1977 and chief from 1980 to 2001. From 1989 to 1995, he also served as Marion B. Sulzberger professor of dermatology at the Uniformed Services University of the Health Sciences in Bethesda. On August 1, 1995, he was appointed Director of NIAMS.

Dr. Katz's studies of Langerhans cells and epidermally derived cytokines have demonstrated that skin is a critical component of the immune system both in its normal function and as a target in immunologically mediated diseases. He has also made seminal discoveries in the field of inherited and acquired blistering skin diseases.

At NCI, he has led a program of investigations in fundamental biological and clinical problems in neoplastic and inflammatory diseases of the skin. He has trained a large number of immunodermatologists from the United States and abroad. These individuals are now leading their own independent research programs.

Dr. Katz has received many Government- and private-sector honors and awards, including the Lifetime Achievement Award from the American Skin Association, the Presidential Distinguished Rank Award, Presidential Executive Meritorious Rank Award, PHS Superior Service Award, NIH Director's Award, Sulzberger Lecture Award from the American Academy of Dermatology, Martin Carter Mentor Award from the American Skin Association, Alfred Marchionini Gold Medal, Outstanding Alumnus Award of Tulane University School of Medicine, Stephen Rothman Memorial Award of the Society for Investigative Dermatology (SID), Inflammatory Skin Disorders Research Award, Scleroderma Foundation's Messenger of Hope Award, honorary membership in many international dermatologic societies, and election into the Institute of Medicine of the National Academy of Sciences.

He has served many scientific organizations in leadership positions such as president of the Society for Investigative Dermatology (SID), membership on the board of directors of SID and of the Association of Professors of Dermatology, secretary-general of the World Congress of Dermatology, and secretary-treasurer of the Clinical Immunology Society. In addition, he was named president of the International League of Dermatological Societies in 1997, for a 5-year term.

Dr. Katz has also served on the editorial boards of most clinical and investigative dermatology journals and many immunology journals. He has authored or coauthored more than 200 scientific articles and 60 book chapters and edited several conference proceedings and books.

NIAMS Directors

Name
In Office From
To
Lawrence E. Shulman
April 1986 October 1994
Michael D. Lockshin (Acting)
November 1994 July 1995
Stephen I. Katz
August 1995  

Research Programs
Extramural | Intramural

NIAMS supports a multidisciplinary program of basic and clinical investigations, epidemiologic research, research centers, and research training for scientists within its own facilities as well as grantees at universities and medical schools nationwide. It also supports the dissemination of research results and information through the National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse and through the NIH Osteoporosis and Related Bone Diseases' National Resource Center.

The Extramural Program supports research via grants and contracts in four branches: Rheumatic Diseases, Musculoskeletal Diseases, Skin Diseases, and Muscle Biology. Support also is provided for the Epidemiology/Data Systems Programs and the Centers Program. A wide array of basic and clinical research and research training in the fields of rheumatology, muscle biology, orthopaedics, bone and mineral metabolism, and dermatology are being pursued through these programs.

The NIAMS Intramural Research Program conducts basic research in structural biology, biology of the immune and inflammatory systems, biology of the skin, muscle biophysics, and development of bone, cartilage, skin, and muscle. It does clinical research on lupus, rheumatoid arthritis, inflammatory muscle diseases, immunodeficiencies, and autoinflammatory disorders such as Familial Mediterranean Fever.

Extramural Research Program

Rheumatic Diseases Branch. The mission of this program is to promote and support research leading to prevention, diagnosis, and cure of rheumatic and related diseases. The Branch supports basic, epidemiologic, and clinical research on etiology, pathogenesis, course, interventions, and outcomes in rheumatic and related diseases.

  • Immunology and Inflammation Program. This program supports basic research aimed at understanding the etiology, pathogenetic mechanisms, and systems affected in rheumatoid arthritis, adjuvant and chemically induced inflammatory arthritis, systemic lupus erythematosus, systemic scleroderma, and general autoimmunity. Relevant research comes from the areas of genetics, biochemistry, cellular and molecular biology, biophysics, enzymology, immunology, pathology, and physiology.
     
  • Cartilage and Connective Tissue Program. This program supports research aimed at understanding normal function of cartilage and components of connective tissues, and etiology and pathogenic mechanisms in osteoarthritis and heritable disorders of connective tissue.
     
  • Behavioral and Prevention Research Program. This program seeks to foster basic and clinical biopsychosocial research in arthritis, systemic lupus erythematosus, fibromyalgia, and related diseases. Research supported includes examination of behavioral, psychological, and social factors and their interaction with physiological processes in the prevention, etiology, course, management, and outcomes of disease. Multidisciplinary collaboration is encouraged.
     
  • Genetics and Clinical Studies Program. This program supports genetic studies in rheumatic diseases, both in animal models and in humans; clinical trials and complex clinical studies, including epidemiology, outcomes, and prevention of rheumatic and related diseases; and research on Lyme disease and infection-related arthritis.
     
  • Epidemiology and Data Systems Programs. The epidemiology program provides an administrative core for efforts to encourage epidemiologic research in the fields of rheumatic, musculoskeletal, and skin diseases. Epidemiologic studies of these diseases contribute knowledge related to prevalence, economic and social burdens, natural history, risk factors, and etiologies.

    The data systems program fosters systematic acquisition, storage, retrieval, and analysis of information concerning arthritis and skin diseases. Program effort is focused on ensuring validity and comparability of data collected in separate institutions, and integrating data resources with data needs.

Musculoskeletal Diseases Branch. This program supports studies of the skeleton and associated connective tissues. Broad areas of interest include skeletal development, metabolism, mechanical properties, and responses to injury and treatment. Research on osteoporosis and osteoarthritis diseases afflicting many of the Nation's growing population of older people are major areas of emphasis. Other diseases and skeletal disorders under investigation are osteogenesis imperfecta, a genetic disorder that leads to fragile, easily fractured bones; Paget's disease, which results in irregular bone formation and subsequent deformity; and disorders of bone growth and development such as rickets and osteomalacia.

Other studies focus on the causes and treatment of acute and chronic injuries, including carpal tunnel syndrome, repetitive stress injury, and low back pain. The program supports development of technologies with the potential to improve treatment of skeletal disorders and facilitate the repair of trauma in the normal skeleton. These include drugs and nutritional interventions, joint replacement, bone and cartilage transplantation, and gene therapy. Sports medicine and musculoskeletal fitness are also areas of special research emphasis.

Research areas supported through this branch include:

  • Bone diseases: epidemiology and development of disease; environmental and genetic risk factors; and treatment, prevention, and diagnosis
     
  • Bone biology: mechanisms of bone resorption; hormone, growth-factor, and cytokine effects on bone-resorbing and bone-forming cells; regulation of bone growth and development; interactions among proteins, minerals, and cells in bone; and mechanisms of mineralization
     
  • Orthopaedic research: skeletal architecture and mechanical properties; mechanisms of fracture repair; musculoskeletal tissue engineering; biomaterials, orthopaedic devices, and joint replacement and repair; rehabilitation; occupational and recreational/sports injuries; and clinical orthopaedic and sports medicine
     
  • Osteoarthritis and diagnostic imaging: clinical studies of osteoarthritis; bone quality; and macro- and micro-scale imaging of bones and joints

Muscle Biology Branch . The mission of this program is to promote and support research to increase understanding of mechanisms underlying normal and abnormal muscle function and development. An important emphasis is basic and clinical research on the pathogenesis and interventions for muscular dystrophy and other muscle disorders.

  • Muscle Biophysics and Cell Biology Program. This program supports basic research increasing understanding of muscle function and use of energy. Topics include the molecular structure of muscle, the molecular mechanisms that produce force and motion, and the assembly of muscle components, including those responsible for contraction and regulation of muscle action.

    Specific research covered by the program includes:
    • Muscle physiology
    • Processes of muscle self-assembly
    • Structure and function of muscle and of individual muscle proteins
    • Molecular and atomic mechanisms of muscle contraction and force generation
    • Structure and mechanical properties of muscle membranes and associated substances
    • Electrophysiology of muscle membranes and regulation of activity
       
  • Muscle Diseases, Fitness, and Development Program. This program supports research on muscle disorders and genetic diseases, such as Duchenne/Becker muscular dystrophy, facioscapulohumeral dystrophy, myotonic dystrophy, myotonias, and malignant hyperthermia. Another main area is the central role of muscle in human physiology and exercise. One aim is to understand the alterations in muscle resulting from increased exercise and, conversely, the atrophy that follows immobilization during injury or illness.

    Specific research covered by the program includes:
    • Molecular basis of genetic muscle diseases, such as muscular dystrophy
    • Inflammatory muscle diseases and inflammation resulting from exercise or injury
    • Development of more satisfactory methods of treatment for muscle diseases and disorders
    • Effects of therapeutic drugs and abused substances on basic muscle processes
    • Cellular basis for impaired muscle function in disease
    • Molecular mechanisms of muscle repair and regeneration
    • Muscle development and specialization, including genetic processes of muscle assembly
    • Musculoskeletal fitness and adaptive biology, including metabolism and exercise physiology
    • Role of growth factors and hormones
    • Sports medicine, and muscle injury and repair

Skin Diseases Branch. Research studies supported by this program are increasing understanding of the mechanisms underlying normal and abnormal skin function and development. Research investigations are conducted on the molecular structures of various skin cells, the immunologic functions of the skin in normal and disease conditions, and the development of diagnostic tests and effective therapies for an array of skin diseases that can cause discomfort, disfigurement, and/or chronic disability. The range of skin diseases includes keratinizing disorders such as psoriasis and ichthyosis, atopic dermatitis and other chronic inflammatory skin disorders, blistering diseases such as epidermolysis bullosa and pemphigus, disorders of pigmentation such as vitiligo, and disorders of the hair and nails.

Basic science and disease areas in skin research include:

  • Metabolic studies of skin

  • Immunologically mediated skin disorders

  • Disorders of keratinization, pigmentation, and hair growth

  • Photobiology, photoallergy, and phototoxic reactions

  • Bullous diseases and the basement membrane of skin

  • Acne and physiologic activity of sebaceous glands

  • Skin manifestations of diffuse connective tissue disorders

  • Heritable connective tissue diseases

  • Skin manifestations of HIV infection and AIDS

Centers Program. NIAMS supports three types of Center mechanisms to advance the NIAMS mission and to meet the needs of the public and the research community.

The Multidisciplinary Clinical Research Centers (MCRC) focus on the assessment and improvement of clinical outcomes for patients with arthritis and musculoskeletal and skin diseases. Patient-oriented research is derived from many disciplines, and the center director is a clinician/scientist.

The Specialized Centers of Research (SCORs) are targeted to specific diseases and are aimed at expediting transfer of advances in basic science into clinical applications and improved patient care. NIAMS supports SCORs in rheumatoid arthritis, osteoporosis, osteoarthritis, systemic lupus erythematosus, and scleroderma.

Each Research Core Center (RCC) is directed to one of three research areas: skin diseases, musculoskeletal disorders or rheumatic diseases. RCCs have a minimum of two research cores and include a pilot and feasibility program.

Intramural Research Program

The NIAMS Intramural Research Program (IRP) consists of 11 main components: Office of the Clinical Director, Office of Science and Technology, Arthritis and Rheumatism Branch, Autoimmunity Branch, Cartilage Biology and Orthopaedics Branch, Genomics and Genetics Branch, Molecular Immunology and Inflammation Branch, Laboratory of Muscle Biology, Laboratory of Skin Biology, Laboratory of Structural Biology Research, and Protein Expression Laboratory.

The Office of the Clinical Director implements innovative clinical research programs that relate to the broad field of rheumatologic, musculoskeletal and skin disorders. Through specific programs in translational research, rheumatology fellowship training, and health partnership, the Office of the Clinical Director plays an important role in establishing innovative therapeutic paradigms, medical education in the field of rheumatology, and by reaching out to the community to reduce health care disparities and improve the understanding of rheumatic and related diseases.

  • Translational Research: The Bridge Between Basic Research and Clinical Disease
    A goal of clinical investigation is to bridge information gained from laboratory research with that afforded by clinical experience. Carefully designed observational and interventional studies provide opportunities to verify basic biological understanding of disease. These studies then bring back to the laboratory new insight into the biology of the human body.
  • Rheumatology Fellowship Program
    The NIAMS/NIH Rheumatology Fellowship Training Program is dedicated to the clinical and research training of physicians wishing to pursue careers in biomedical or translational research related to the rheumatic diseases. The fellowship program is two years in duration, with extensions available for individuals interested in advanced research training. The program is accredited by the ACGME and graduates are eligible to sit for the certifying examination in the subspecialty of rheumatology.
  • NIAMS Community Health Center
    The NIAMS Community Health Center is a health information and medical center providing health care services to people affected by arthritis, lupus, and other rheumatic diseases. The health center offers patient care with access to a specialist, health information and education programs, and referral to clinical investigations for the prevention and treatment of rheumatic diseases. The health center is located in upper northwest Washington, D.C.

The Office of Science and Technology encompasses an infrastructure of research and support facilities designed to enhance the research capabilities of all scientists of the IRP. In addition, members advise the Scientific Director, Laboratory and Branch Chiefs, and other key officials on collaborative and cooperative activities, training programs, and proper use of laboratory animals; and negotiate and facilitate scientific collaborations that involve trans-institute and trans-NIH initiatives and agreements. The Career Development Section serves as a resource to all NIAMS students, fellows, and their sponsors to ensure that NIAMS continues to attract the best fellows and provide them with a genuine growth experience. The Flow Cytometry Facility provides state-of-the-art multiparameter analytic and sorting capabilities for IRP investigators. The Laboratory Animal Care and Use Section provides support to all IRP branches and laboratories using animals. The Light Imaging Section functions as a core facility, offering IRP scientists access to state-of-the-art light imaging equipment and expertise in light imaging techniques. The Scientific Interchange Section facilitates intramural-extramural interchange on scientific and programmatic levels. The Biodata Mining and Discovery Section assesses the scientific computing needs of IRP scientists, and develops strategies and designs computational support for researchers. The X-Ray Crystallography Facility is an NIAMS core facility that provides equipment, training, assistance, and technological innovations to determine three-dimensional structures of protein and other macromolecules (large biological molecules).

The Arthritis and Rheumatism Branch (ARB) conducts a variety of basic and clinical investigations. The historical focus of the ARB has been the study of the autoimmune rheumatic diseases, particularly rheumatoid arthritis, systemic lupus erythematosus, and myositis. Current studies focus on inflammatory and genetic diseases affecting the musculoskeletal system.

The Autoimmunity Branch (AB) conducts basic and clinical research to develop new insights into the molecular basis of autoantibody formation. Autoimmune diseases such as lupus are characterized by the formation of tissue-affecting autoantibodies. The basis of this formation is not known. Branch scientists are using molecular and cell-biologic techniques as well as multiparameter flow cytometry (a technique that allows large numbers of individual cells to be characterized in detail) to analyze autoantibody formation in patients with lupus and other autoimmune diseases.

The Cartilage Biology and Orthopaedics Branch (CBOB) , consisting of the Developmental Biology , Orthopaedics , and Tissue Engineering Sections , conducts basic and clinical research directed towards understanding the mechanisms regulating cartilage function, the basis of cartilage and orthopaedic diseases (such as osteoarthritis), and the development of functional cartilage tissue substitutes. Researchers are using cellular, molecular, bionomic, and bioengineering approaches to analyze cartilage development, growth, diseases, and aging, as well as applying the emerging technology of tissue engineering for functional cartilage replacement.

The Genomics and Genetics Branch (GGB) identifies and characterizes susceptibility genes for rheumatic and inflammatory diseases. This includes the study of Mendelian autoinflammatory diseases such as Familial Mediterranean Fever (FMF), tumor necrosis factor- associated periodic syndrome (TRAPS), neonatal onset multisystem inflammatory disease (NOMID), and the syndrome of pyogenic arthritis with pyoderma gangrenosum and acne (PAPA). The Branch also studies genetically complex conditions such as rheumatoid arthritis. Included in the Branch are the Inflammatory Biology Section and the Genomics Section.

The Molecular Immunology and Inflammation Branch (MIIB) conducts basic and clinical investigations on the molecular mechanisms underlying immune and inflammatory responses in rheumatic and autoimmune diseases. A major focus is the study of receptor-mediated signal transduction and how these events link to the regulation of genes involved in inflammatory responses. Included in the Branch are the Lymphocyte Cell Biology, Chemical Immunology, and Molecular Inflammation Sections.

The Laboratory of Muscle Biology (LMB) conducts a broad range of research in muscle and structural biology. This includes the molecular mechanisms of contraction, muscle elasticity and plasticity, differentiation and assembly of muscle cells, pathobiology of muscle diseases, and the development and application of emerging technologies in proteomics and nanotechnology in muscle research.

The Laboratory of Skin Biology (LSB) conducts basic research on the skin and its diseases, emphasizing the epidermis. Basic studies include structural proteins and enzymes and their genes specifically expressed in the epidermis; processes by which these molecules are assembled to form a normal epidermis; identifying and characterizing factors controlling their expression; and processes of abnormal keratinization (development of the principal protein of the epidermis) that occur in genetic skin diseases.

The Laboratory of Structural Biology Research (LSBR) conducts research into the structural basis of 1) the assembly and functioning of macromolecules and their complexes (such as viruses, machines, and cytoskeletons), and 2) the mechanisms and proteins that control their assembly. These studies make extensive use of cryoelectron microscopy and three-dimensional image processing in studies of virus infection and replication; renewal of the epidermis, with maintenance of barrier function; prionogenesis (structural transitions of infectious proteins called prions); and intracellular protein quality control by energy-dependent proteases.

The Protein Expression Laboratory (PEL) plans and conducts research on the expression, purification, and structural characterization of Human Immunodeficiency Virus (HIV) and HIV-related proteins. Laboratory scientists also collaborate with NIH intramural researchers studying the structure and function of HIV and HIV-related proteins. The lab serves as a support and resource group for the expression and purification of these proteins.

Communications

The Office of Communications and Public Liaison (OCPL) leads the NIAMS efforts in information dissemination, public input, and health education. OCPL disseminates health and research news and updates, creates print and Web publications, manages the NIAMS Web site, coordinates outreach and promotion, and serves as a point of contact for the media, the public, and public organizations. OCPL oversees the NIAMS Information Clearinghouse, which operates a toll-free service to provide information and information sources on arthritis and rheumatic diseases, musculoskeletal and connective tissue disorders, and skin diseases. OCPL also oversees the NIH Osteoporosis and Related Bone Diseases~National Resource Center, which disseminates information on bone diseases.

 

 
This page was last reviewed on July 23, 2004 .

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