SUMMARYThe spine, pelvic bones and long bones of the lower extremities are common sites for insufficiency fractures. Cases of sternum insufficiency fractures have rarely been reported among elderly patients. Insufficiency fractures tend to occur in bones with decreased mechanical strength especially among elderly patients, in postmenopausal women and patients with underlying diseases. We describe a case of spontaneous sternum insufficiency fracture in a healthy man, with no known risk factors to fracture, or previous history of fractures. Sternum insufficiency fracture is a rare cause of chest pain. This case serves to remind the emergency physician to remain vigilant for other non-cardiac, non-pulmonary and non-traumatic causes of chest pain, especially among patients with known risk factors such as osteoporosis, chronic obstructive pulmonary disease, rheumatoid arthritis, systemic lupus erythematosus and patients on long-term steroid treatment. If diagnosed correctly, these patients can be discharged and treated as outpatients as this case emphasises. BACKGROUND

Rhabdomyolysis is a potentially life-threatening condition to be considered when muscular damage is suspected. We present a case of a 39-year-old woman who developed rhabdomyolysis after prolonged circulatory insufficiency to the legs, leading to life-threatening complications including bilateral tibial compartment syndrome, acute kidney failure, hyperkalaemia with cardiac arrhythmia and finally lifesaving bilateral transfemoral amputation. This case emphasises that early diagnosis, removal of triggering factor, early and aggressive fluid therapy and treatment and prevention of complications are essential for the patient's morbidity and mortality.