Spontaneous bilateral humeral head fractures occurring simultaneously in a woman with rheumatoid arthritis

A 67-year-old woman with a 15-year history of seropositive rheumatoid arthritis developed acute night pain in both shoulders. Examination revealed bilateral swelling and joint mobility impairment. Ultrasonography disclosed joint effusions which were hemorrhagic on aspiration. Radiographs showed the presence of a four-part fracture of both humeral heads. Bilateral humeral head fractures can occur spontaneously in patients with rheumatoid arthritis and osteoporosis. Repeated use of crutches could be a predisposing factor.