EURORAD ESR

Case 10670

Atypical femoral shaft stress fractures in post menopausal patient on bisphosphonate therapy

Author(s)
D. Alison, S. Siebert, S. Singh, I. Gunatunga.

Royal Gwent Hospital,
Cardiff Road,
Newport, NP20 2UB.
Email:d.alison564@btinternet.com
 
Patient
female, 69 year(s)
 
 
  • Figure 1
    AP radiograph right femur

    Focal lateral cortical thickening and beaking in distal diaphysis of femur.

     
    Area of Interest: Bones; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Demineralisation-Bone;
     
     
  • Figure 2
    Isotope bone scan

    Bilateral symmetrical uptake of tracer in lateral cortex of symptomatic and asymptomatic femur.

     
    Area of Interest: Bones; Imaging Technique: Nuclear medicine conventional; Procedure: Diagnostic procedure; Special Focus: Demineralisation-Bone;
     
     
  • Figure 3
    AP radiograph left femur

    Lateral cortical thickening and beaking in asymptomatic femur.

     
    Area of Interest: Bones; Imaging Technique: Plain radiographic studies; Procedure: Diagnostic procedure; Special Focus: Demineralisation-Bone;
     
     
  • Figure 4
    Coronal STIR MRI both femurs

    Bilateral cortical thickening and fracture in distal femurs. Symptomatic right femur demonstrates high signal bone odema in medulla. Asymptomatic side demonstrates no odema.

     
    Area of Interest: Bones; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Demineralisation-Bone;
     
     
  • Figure 5
    Coronal T1 MRI both femurs

    Bilateral symmetrical lateral cortical thickening in distal femurs with beaked margin. Fracture line very subtle.

     
    Area of Interest: Bones; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Demineralisation-Bone;
     
     
Focal lateral cortical thickening and beaking in distal diaphysis of femur.
 
Bilateral symmetrical uptake of tracer in lateral cortex of symptomatic and asymptomatic femur.
 
Lateral cortical thickening and beaking in asymptomatic femur.
 
Bilateral cortical thickening and fracture in distal femurs. Symptomatic right femur demonstrates high signal bone odema in medulla. Asymptomatic side demonstrates no odema.
 
Bilateral symmetrical lateral cortical thickening in distal femurs with beaked margin. Fracture line very subtle.
 
 
 
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