Nucl Med Mol Imaging.  2018 Aug;52(4):311-317. 10.1007/s13139-018-0533-x.

Prevalence and Risk Factors of Atypical Femoral Fracture Bone Scintigraphic Feature in Patients Experiencing Bisphosphonate-Related Osteonecrosis of the Jaw

Affiliations
  • 1Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. abc2000@knu.ac.kr kune2151@naver.com
  • 2Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea.
  • 3Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, South Korea.

Abstract

PURPOSE
Bisphosphonate (BP) is the first-line therapy for the management of osteoporosis. BP-related osteonecrosis of the jaw (BRONJ) and atypical femoral fracture (AFF) are increasingly common comorbidities in patients with osteoporosis under long-term BP treatment. The aim of this study was to evaluate the incidence and risk factors for AFF features on bone scintigraphy in patients with BRONJ.
METHODS
Among total of 373 BRONJ patients treated between September 2005 and July 2014, 237 (220 women, 17 men; median age 73 years) who underwent three-phase bone scintigraphy were enrolled for this retrospective study. AFF features on bone scintigraphy and the related clinical factors were assessed.
RESULTS
Among 237 patients with BRONJ, 11 (4.6%) showed AFF features on bone scintigraphy. BP medication duration (p = 0.049) correlated significantly with AFF features on bone scintigraphy in patients with BRONJ. BP intake duration of 34 months was the cutoff value for predicting the presence of AFF features on bone scintigraphy. Among the patients with BRONJ, all those with AFF features on bone scintigraphy were female patients with osteoporosis who were on oral BP medication; however, these factors were not significantly different along with AFF features on bone scintigraphy.
CONCLUSIONS
The incidence of AFF features on bone scintigraphy was relatively high in patients with BRONJ. A careful observation of patients presenting with the AFF features on bone scintigraphy may be needed, particularly for female BRONJ patients with osteoporosis who have been on BP medication for over 34 months.

Keyword

Bone scintigraphy; Atypical femoral fracture; Bisphosphonate-related osteonecrosis of the jaw; Prevalence

MeSH Terms

Bisphosphonate-Associated Osteonecrosis of the Jaw*
Comorbidity
Female
Femoral Fractures*
Humans
Incidence
Jaw
Male
Osteonecrosis
Osteoporosis
Prevalence*
Radionuclide Imaging
Retrospective Studies
Risk Factors*
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