Endocrinol Metab.  2011 Jun;26(2):150-154. 10.3803/EnM.2011.26.2.150.

Pregnancy-induced Osteoporosis Combined with Multiple Compression Fractures: A Case Report

• Lee JE
• Jang JS
• Ko SH
• Kim MH
• Lim DJ
• Kang MI
• Cha BY
• Hong SH
• Bae JS
• Ryu KS

• KMID: 1497722
• DOI: http://doi.org/10.3803/EnM.2011.26.2.150

Abstract

Pregnancy associated osteoporosis (PAO) is a rare condition. It may affect women during pregnancy or after the delivery and it can induce severe back pain. Physicians can find multiple compression fractures on the plain images of these patients. However, little is known about PAO, including the prevalence, the cause, the risk factors and the prognosis. Herein we report on a case of PAO in a 38-year-old female who suffered from severe back pain induced by multiple vertebral compression fractures. After excluding the possibility of unknown malignancy, the patient underwent vertebroplasty to improve the clinical symptom. The bone biopsy results confirmed multiple benign acute compression fractures. The patient was treated with oral bisphosphonate, calcium and vitamin D. She showed clinical improvement without developing any additional vertebral fracture. When young women during pregnancy or just after the delivery complain of persistent back pain, PAO should be considered in the differential diagnosis, and early recognition and treatment are needed for PAO.

Keyword

Compression fractures; Osteoporosis; Pregnancy

MeSH Terms

Adult
Back Pain
Biopsy
Calcium
Diagnosis, Differential
Female
Fractures, Compression
Humans
Osteoporosis
Pregnancy
Prevalence
Prognosis
Risk Factors
Vertebroplasty
Vitamin D
Calcium
Vitamin D

Figure

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  Fig. 1 Thoracolumbar (T-L) spine lateral and lumbar (L) spine lateral plain films show multiple compression fractures at T12 through L5.

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  Fig. 2 Whole body bone scan shows fractures in right 4th, 5th anterior and 9th axillary ribs and left 5th anterior ribs. Compression fractures are shown in T9, and T12 to L3 vertebrae.

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  Fig. 3 Sagittal T1 and T2 weighted MR images of lumbar spine show acute compression fractures at T12 through L5.

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  Fig. 4 Low bone mineral density at lumbar spine and left femur is demonstrated, indicating 'below the expected range for age'.

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  Fig. 5 The pathologic findings of bone biopsy show multiple lymphocytic aggregations and normal trabecular formation, consistent of acute benign compression fracture (A, H&E staining, × 100; B, H&E staining, × 400).

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