Insufficiency fracture. A survey of 60 cases and review of the literature

Soubrier, Martin; Dubost, Jean‐Jacques; Boisgard, Stéphane; Sauvezie, B; Gaillard, P; Michel, J.-L.; Ristori, J. M.

doi:10.1016/s1297-319x(03)00024-1

Cited by 124 publications

(97 citation statements)

References 33 publications

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“…The radioactive tracer is incorporated into the cells responsible for bone remodelling within 24 h following the fracture. However, this technique is not sufficiently specific because bone turnover can be increased in a wide variety of others conditions including tumours, infections or inflammations [4,9,14].…”

Section: Discussionmentioning

confidence: 99%

Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report

Khy

Wyssa

Bianchi

2012

Journal of Ultrasound

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KEYWORDSFatigue fracture; Sonography; Ultrasound; Stress fracture.Abstract We report the case of a 35 years old patient presenting with bilateral pain in the medial aspect of both knees. Ultrasound examination revealed hyperechoic appearance of the subcutaneous tissue and periarticular soft tissue bilateral. Color Doppler studies showed significant vascular signals at the surface of the tibial plateaux. US appearance, together with clinical findings, suggested a diagnosis of simultaneous bilateral fatigue fracture. An MRI confirmed the diagnosis and the patient's symptoms resolved with rest. US may be a useful imaging tool in the diagnosis of stress fracture.Sommario Presentiamo il caso di un paziente di 35 anni con dolore bilaterale nella parte mediale delle ginocchia. L'ecografia evidenziava ipoecogenicità del tessuto sottocutaneo e delle parti molli periarticolari bilateralmente. L'esame con color Doppler mostrava significativi segnali vascolari in corrispondenza del piatto tibiale. L'aspetto ecografico, associato ai segni clinici, suggeriva la diagnosi di simultanea frattura da fatica, bilaterale. La risonanza magnetica confermava la diagnosi e i sintomi del paziente regredivano con il riposo. L'ecografia può essere un'utile metodica nella diagnosi frattura da stress. ª

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Section: Discussionmentioning

confidence: 99%

Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report

Khy

Wyssa

Bianchi

2012

Journal of Ultrasound

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“…The latter fracture was defined as an insufficiency fracture of the sternum. In a retrospective survey by Soubrier et al (2003) on all of the insufficiency fractures except spinal fractures, only one sternal fracture (1.1%) was identified among 91 insufficiency fractures. To the best of our knowledge, only 41 cases including the present two cases, with insufficiency fractures of the sternum secondary to osteoporosis have been reported in the past several decades (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…The spine, pelvis, and lower extremities are commonly affected by these fractures, whereas insufficiency fracture of the sternum is rare. Approximately 40 cases with sternal insufficiency fractures have been reported in the literature (Itani et al 1982;Cooper 1988;Chen et al 1990;Sapherson and Mitchell 1990;Schapia et al 1995;Benbouazza et al 2003;Min and Sung 2003;Soubrier et al 2003;Ragucci and Vainrib 2005;Lin and Ponampalam 2006) and the fracture was classified as either the buckling type or nonbuckling type as suggested by Chen et al (1990). A buckling sternal fracture was defined as a sternal deformity in which the upper portion of the sternum was located posterior to the lower portion, and in which there was no tion.…”

confidence: 99%

Insufficiency Fracture of the Sternum Simulating Myocardial Infarction: Case Report and Review of the Literature

Horikawa¹,

Miyakoshi

Kodama³

et al. 2007

Tohoku J. Exp. Med.

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Insufficiency fracture is a type of stress fracture that occurs when stress is applied to the bone with less than the normal elastic resistance, as in osteoporosis. Insufficiency fracture of the sternum is rare among all kinds of fractures. We describe two cases with insufficiency fractures of the sternum secondary to osteoporosis and thoracic kyphotic deformity. Both of the present cases, a 76-year-old woman and a 65-year-old woman, presented with severe anterior chest pain simulating myocardial infarction. However, cardiopulmonary examinations including chest radiographs, electrocardiograms, and laboratory tests were normal. Lateral radiographs of the sternum in both patients showed insufficiency fractures of the sternum. Conservative treatment with rib bandaging/bracing and analgesics relieved their symptoms. Clinical behavior, type of sternal insufficiency fractures, and mechanism of the fracture are reviewed from perusal of the literature. We emphasize that sternal insufficiency fracture should be considered in the differential diagnosis of acute chest pain in the elderly along with myocardial infarction or pulmonary embolism. insufficiency fracture; sternum; osteoporosis; myocardial infarction

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“…Yetersizlik kırıklarının tanısında direkt radyografilerin değerlendirilmesi osteoporoz ve gaz gölgesi gibi nedenlere bağlı olarak her zaman mümkün olmayabilir. (2,7,10). Direkt grafiler, bu hastaların tanısında düşük duyarlılığa sahip olduğundan tanı konulamayan durumlarda kemik sintigrafisi ve bilgisayarlı tomografi oldukça duyarlı tanı araçlarıdır (1).…”

Section: Tartışma Ve Sonuçunclassified

“…Superior ve inferior pubik ramuslarda bilateral yetersizlik kırık hatları Resim 2. Üç boyutlu pelvis BT: Pelviste inferior ve superior pubik ramusun posteriorlarında bilateral yetersizlik kırıkları ve protrüzyo asetabuli çalışmada hastaların %65'inde direkt radyografilerde, %87,5'inde sintigrafide, %98,1'inde ise bilgisayarlı tomografide kırık hattı görülmüştür (7). Bizim olgumuzda ise pelvis grafisinde bilateral superior ve inferior pubik ramusda kırık hattı görülmekle birlikte daha net görüntü elde edebilmek ve varsa sakrum kırığını da görebilmek açısından üç boyutlu pelvis tomografisi çektirildi.…”

Section: Tartışma Ve Sonuçunclassified

Polimiyalji Romatika Tanılı Hastada Bilateral Pubik Ramus Yetersizlik Kırığı

Sucuoğlu

Sarı

Gün

2012

tod

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Sıklıkla gözden kaçabilen ve tanı konulması zor olan pubik ramus yetersizlik kırıkları genellikle postmenopozal yaşlı kadınlarda görülmektedir. Bel, kalça ve kasık ağrısı şikayetleri ile başvuran hastalarda tanının gecikmesi, konservatif tedavisi mümkünken gereksiz invazif girişimler yapılmasına neden olmaktadır. Bu amaçla kullanılabilecek kemik sintigrafisi ve bilgisayarlı tomografi incelemeleri oldukça duyarlı tanı araçlarıdır. Osteoporoz, kortikosteroid kullanımı gibi kırık oluşumu açısından risk faktörlerine sahip yaşlı hastalarda, pubik yetersizlik kırıklarının doğru tanı ve tedavisi için klinik şüphe önem taşımaktadır. Biz de bu açıdan polimiyalji romatikaya bağlı kortikosteroid kullanan, osteoporozlu yaşlı bir kadın hastada gelişen bilateral pubik ramus yetersizlik kırığının tanı ve tedavisini literatür eşliğinde sunuyoruz. 24Pubic ramus insufficiency fractures, which are often overlooked and difficult to diagnose, are usually seen in postmenopausal elderly women. While treatment with conservative methods is possible, delays in diagnosis for patients with waist, hip and groin pain complaints may result in unnecessary invasive procedures. Bone scintigraphy and computer tomography are very sensitive diagnostic tools that can be used for this purpose. Elderly patients with osteoporosis and who use corticosteroids have higher risk factors for the occurence of such fractures. Therefore, in these patients, clinical suspicion is important for accurate diagnosis and treatment of pubic ramus insufficiency fractures. Consequently, along with the literature, we present a case of diagnosis and treatment of pubic ramus insufficiency fractures development in an elderly woman with osteoporosis who uses corticosteroids due to polymyalgia rheumatica. (Turkish Journal of Osteoporosis 2012;18:24-6)

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Insufficiency fracture. A survey of 60 cases and review of the literature

Cited by 124 publications

References 33 publications

Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report

Bilateral stress fracture of the tibia diagnosed by ultrasound. A case report

Insufficiency Fracture of the Sternum Simulating Myocardial Infarction: Case Report and Review of the Literature

Polimiyalji Romatika Tanılı Hastada Bilateral Pubik Ramus Yetersizlik Kırığı

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