Patients with rheumatoid arthritis are often associated with osteoporosis. Bone and joint destruction is a major cause of disability in patients with rheumatoid arthritis, and the main manifestations of bone and joint damage are bone erosion and periarticular and systemic osteoporosis. Studies have found a two-fold increase in osteoporosis in patients with rheumatoid arthritis compared to healthy controls, and rheumatoid arthritis is the most prominent of the arthritis associated with osteoporosis. When rheumatoid arthritis causes synovitis, the function of osteoclasts is enhanced and the function of osteoblasts is reduced, which results in a greater loss of bone mass than synthesis, leading to osteoporosis. At the same time, synovitis can also lead to changes in local blood circulation, affecting the supply of bone nutrients, which can also increase the occurrence of osteoporosis. Therefore, osteoporosis is a common skeletal tissue change on imaging in patients with rheumatoid arthritis. In addition, medication in patients with rheumatoid arthritis may also lead to osteoporosis. One common medication is glucocorticoids. Because hormonal drugs can slow down collagen synthesis in osteoblasts and prevent the transformation of osteogenic cells into osteoclasts, they can also enhance the activity of osteoclasts and increase bone resorption. In addition, the gastrointestinal side effects associated with NSAIDs and immunosuppressants can also affect the intake and absorption of nutrients, resulting in nutritional deficiencies and thus affecting the metabolic function of normal bone tissue. Therefore, patients with rheumatoid arthritis must actively treat and control the primary disease to stop rheumatoid arthritis from causing osteoporosis at the root. In addition, calcium supplements are needed to prevent and treat osteoporosis, especially in patients on hormone therapy. The absorption of calcium requires the participation of vitamin D. Therefore, while taking calcium supplements, attention should be paid to vitamin D preparations such as cod liver oil, or calcium supplements with vitamin D complex. In addition, rheumatoid arthritis patients need to take drugs for a long time, so the physician should be aware of the need to protect the gastrointestinal function of patients during the treatment process, to prevent patients from poor gastrointestinal function due to the long-term use of drugs that affect the absorption of calcium and nutrients.