Turkish Journal of Geriatrics
2015 , Vol 18, Issue 2
ATYPICAL SACRAL AND ILIAC BONE INSUFFICIENCY FRACTURES IN A PATIENT RECEIVING LONG-TERM BISPHOSPHONATE THERAPY
1Katip Celebi University Ataturk Training and Research Hospital, Physical Medicine and Rehabilitation, Ä°ZMÄ°R2Katip Celebi University Ataturk Training and Research Hospital, Radiology, Ä°ZMÄ°R Insufficiency fractures are a type of stress fracture occurring in bones with low resistance. The most common cause of insufficiency fractures is postmenopausal osteoporosis. Corticosteroid use, radiotherapy, rheumatoid arthritis, Paget disease, osteomalacia, long-term use of bisphosphonates hyperparathyroidism, diabetes mellitus, primary biliary cirrhosis, renal osteodystrophy are among the other risk factors. These fractures are generally overlooked because the symptomatology is similar to the clinical signs of osteodegenerative diseases, which are common in the elderly, particularly without a history of trauma.
A 73-year-old female patient was admitted to our outpatient clinic with a increase in low back pain intensity and difficulty in walking 3 months ago without a history of any trauma. She had a waddling gait with painful movements of both hips. Lumbar range of motion was normal but painful. On laboratory examination 25(OH) vitamin D3 level was low. Pelvic magnetic resonance imaging showed widespread bone marrow edema at both sacral wings and left iliac bone and signal recordings corresponding to insufficiency fractures in this region. Herein we present a case of an osteoporosis patient with sacral and iliac bone fractures that were treated conservatively.
Keywords : Fractures, Stress; Ilium; Sacrum; Osteoporosis; Aged; Diphosphonates