Femoral bisphosphonate-related insufficiency fractures

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

Fall onto left side.

Patient Data

Age: 74
Gender: Female

No fracture identified. However note the slight cortical thickening in the lateral subtrochanteric region of the right femur.

Increased uptake in the lateral subtrochanteric regions of both proximal femora. 

On both sides, there are oblique subtrochanteric fractures of the femur. Note the thickening of the cortex laterally on the right at the site of the previous plain film and bone scan abnormality.

Case Discussion

The presence of atypical femoral fractures should raise suspicion that these are related to bisphosphonate use.

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