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Multiple insufficiency fractures with severe osteoporosis.
Kousuke Iba1, Takuro Wada, Junichi Takada
1Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo 060-8543, Japan.
Summary
This case study details a rare instance of multiple insufficiency fractures in a 63-year-old woman. Severe osteoporosis, potentially linked to menopause, gastrectomy, and low insulin-like growth factor I, caused these widespread bone breaks.
Area of Science:
- Orthopedics
- Endocrinology
- Geriatrics
Background:
- Multiple insufficiency fractures are uncommon skeletal injuries.
- Osteoporosis significantly increases fracture risk, especially in older adults.
Observation:
- A 63-year-old woman presented with spontaneous insufficiency fractures in multiple locations (ribs, pelvis, sacrum, feet, femur).
- She exhibited severe osteoporosis (BMD 0.267 g/cm²) without metabolic bone disease or metastatic cancer.
- Identified risk factors included postmenopausal status and prior gastrectomy.
Findings:
- Serum insulin-like growth factor I levels were markedly decreased.
- A history of viral hepatitis C was noted.
- The patient's bone mineral density was critically low.
Implications:
- Suggests a potential synergistic effect of multiple conditions (menopause, gastrectomy, low IGF-I, hepatitis C) in causing severe osteoporosis.
- Highlights the complex interplay of factors contributing to fragility fractures.
- Underscores the need for comprehensive assessment in patients with unexplained osteoporosis and fractures.