J Korean Rheum Assoc.  2009 Sep;16(3):228-231.

Long Term Use of Glucocorticoid Induced Osteoporotic Multiple Compression Fractures in Autoimmune Diseases

• Park YS
• Seo WS
• Cho JL
• Kim TH

Abstract

Reduced bone mineral density precedes the development of vertebral fractures in patients under long term glucocorticoid therapy. Osteoporosis is a frequent complication in steroid-dependent patients, and the risk of developing vertebral fractures in these patients is much higher than involutional osteoporosis. We described a 54-year-old patient who presented with autoimmune hepatitis and had a 6-year history of steroid medication. The patient had multiple compression fractures (T10~L5) without trauma, and was treated successfully with multi-level vertebroplasty and an intravenous injection of bisphosphonate without complications.

Keyword

Autoimmune disease; Steroid; Osteoporotic vertebral fracture

MeSH Terms

Autoimmune Diseases
Bone Density
Fractures, Compression
Hepatitis, Autoimmune
Humans
Injections, Intravenous
Middle Aged
Osteoporosis
Vertebroplasty

Figure

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  Fig. 1. Lumbar plain radiography (Pre-operative). Lumbar AP (A) and Lateral (B) x-ray shows multiple compression fractures (T12, L1, 2, 4, 5).

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  Fig. 2. Lumbar MRI. Gadolinium-enhanced sagittal image of the lumbar spine shows signal intensity (arrow) of the fractured vertebral segments (T12, L1, 2, 4, 5).

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  Fig. 3. Lumbar 3D-CT. One month after the MRI check up, the sagittal CT image shows the progression (arrow) of the fractured segments (T10, 11, 12, L1, 2, 3, 4, 5).

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  Fig. 4. Lumbar plain radiography (Post-operative). Lumbar AP (A) and Lateral (B) x-ray shows multiple vertebroplasty segments (T10∼L5).

Reference

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