An unusual cause of spinal bone loss detected by DXA scanning

Abstract

Routine DXA scanning in a 68-year-old asymptomatic man undergoing long-term bisphosphonate treatment for osteogenesis imperfecta showed unexplained loss of bone mineral density in two lumbar vertebrae. Subsequent radiographs revealed a 14-cm abdominal aortic aneurysm eroding the vertebrae. The importance of reviewing all the vertebrae in DXA scans is emphasized, and reasons for the absence of symptoms suggested.

Clinical manifestations of osteogenesis imperfecta in adulthood: An integrative review of quantitative studies and case reports

“…In the case reports, four individuals had an aortic dissection of either Type A (Balasubramanian et al, ; McNeeley, Dontchos, Laflamme, Hubka, & Sadro, ) or B (Balasubramanian et al, ; Byra, Chillag, & Petit, ), and one individual had a coronary artery dissection (Eskola et al, ). Aneurysms of the aorta (Alfirevic & Insler, ; Davies & Davie, ), thoracic artery (Byra et al, ), and coronary artery (Hajsadeghi et al, ) were found in four individuals with OI. Folkestad et al (2016) found that 1.3% of individuals with OI had an arterial dissection or aneurysm, compared to 0.8% in their reference population.…”

“…The majority of individuals had a type I OI ( n = 46), followed by Type III ( n = 13) and IV ( n = 4). Some case reports described the OI clinical phenotype of their participants as being mild ( n = 3) or severe ( n = 1; Benbara, Sellier, Benchimol, & Carbillon, ; Davies & Davie, ; Lyra, Pinto, Ivo, & Nascimento Jdos, ; van der Kley et al, ). A total of 38 (36.2%) of the OI type were not stated or unknown.…”