Korean J Med.  2014 Aug;87(2):240-244. 10.3904/kjm.2014.87.2.240.

Atypical Femoral Fracture in a Patient with Rheumatoid Arthritis

Affiliations
  • 1Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea. sungyk@hanyang.ac.kr
  • 2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 3Department of Radiology, Hanyang University College of Medicine, Seoul, Korea.
  • 4Department of Orthoperdic Surgery, Hanyang University College of Medicine, Seoul, Korea.

Abstract

Atypical femoral fractures are characterized by a subtrochanteric or diaphyseal location. Recent studies have suggested that long-term treatment with bisphosphonates might be associated with the occurrence of atypical femoral fractures. The present report describes a case involving a 60-year-old woman with left buttock pain that was unassociated with trauma. Her hip pain was initially considered to be a symptom of her underlying rheumatoid arthritis, but a plain radiography, bone scintigraphy, and magnetic resonance imaging revealed an insufficiency fracture in the lateral shaft of the left proximal femur. She had been treated with a bisphosphonate for 4.5 years because of a previous vertebral fracture. Her chronic, long-term rheumatoid arthritis and history of bisphosphonate administration were considered to be associated with the development of her atypical femoral fracture.

Keyword

Femoral fracture; Arthritis, Rheumatoid; Alendronate

MeSH Terms

Alendronate
Arthritis, Rheumatoid*
Buttocks
Diphosphonates
Female
Femoral Fractures*
Femur
Fractures, Stress
Hip
Humans
Magnetic Resonance Imaging
Middle Aged
Radiography
Radionuclide Imaging
Alendronate
Diphosphonates
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