Diagnosis of Proximal Femoral Insufficiency Fractures in Patients Receiving Bisphosphonate Therapy

Abstract

The imaging findings of bisphosphonate-related femoral insufficiency fractures, which include a typical proximal diaphyseal location and transverse liner radiolucency through localized thickening of the lateral cortex, allow a specific diagnosis.

Cortical Stress Reaction in Two Patients on Bisphosphonate Therapy: Case Report

“…[6][7][8][9] Magnetic resonance imaging findings of femoral periosteal stress reaction include focal cortical thickening, bone edema, focal cortical resorption cavities and dreaded black line. There is an association between radiographic findings and the presence of clinical symptoms.…”

Bilateral Subtrochanteric Stress Fractures in a Dambali Mystic Dancer-a Unique Complication of a Sufi Ritual. Case Study

“…Bisphosphonates should not be used to treat stress fractures. Rather, these are implicated in proximal femoral insufficiency fractures in patients on longterm bisphosphonate therapy [13,14]. In high risk occupations like military trainees, examining the activities, especially any changes in running/walking distance, running surface, and type of shoe are important red flags for stress fractures [15].…”

Stress Fractures of the Tibia

“…Insufficiency fractures may commonly be due to metabolic bone disease, endocrinopathy, chronic renal disease, post-radiation therapy, smoking, infection, and benign or malignant bone tumors (pathologic fracture). These fractures are frequently observed in the sacrum, vertebral bodies, pubic rami, calcaneus, and proximal femoral diaphysis [10]. Fatigue fractures are overuse injuries.…”