Bilateral undisplaced insufficiency neck of femur fractures associated with short term steroid use: a case report
We present an interesting and unusual case of a patient with bilateral, undisplaced, stress neck of femur fractures associated with short term steroid use. Insufficiency fractures of the neck of femur without preceding trauma have been described in the literature, although bilateral involvement is infrequent.
These fractures have been associated with strenuous exercise, seizures, renal osteodystrophy, fluoride treatment, long term corticosteroid use, amenorrhoea, abnormal anatomy and nutritional/hormonal osteomalacia. The case we present differs to others, in that symptoms developed acutely after only a short course of steroids and with no associated trauma or strenuous Introduction: We present an interesting and unusual case of a 61-year-old woman with bilateral, undisplaced, stress neck of femur fractures associated with short-term steroid use.
Insufficiency fractures of the neck of femur without preceding trauma have been described in the literature, although bilateral involvement is infrequent. Thesefractures have been associated with strenuous exercise, seizures, renal osteodystrophy, fluoride treatment, long-term corticosteroid use, amenorrhoea, abnormal anatomy and osteomalacia due to nutritional and/or hormonal factors.
Case Presentation:The case we present differs from other published reports, in that the patient's symptoms developed acutely after only a short course of steroids and with no associated trauma or strenuous exercise. It is also the only case described where no operative intervention was required.
Conclusion: Our case reiterates the importance of considering insufficiency or stress fractures in high-risk patients who present with musculoskeletal pain.
Institution of bone protection should also be considered in these patients. Morbidity related to delayed treatment has been well documented, so a high level of clinical suspicion is imperative.
Author: Sabahat Gurdezi, Ravi K Trehan and Mark Rickman
Credits/Source: Journal of Medical Case Reports 2008, 2:79
Published on: 2008-03-11
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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