Changes in biochemical markers of bone in patients with insufficiency fractures

Twelve patients presented at our department with low back or buttock pain and were diagnosed as suffering from insufficiency fracture. All patients were evaluated with plain radiographs, magnetic resonance imaging, and/or bone scintigraphy. We also measured biochemical markers of bone turnover in these patients. Bone scintigraphy revealed a high uptake in the fracture site in all patients with insufficiency fracture. Biochemical markers of bone turnover were significantly increased in all patients, but decreased after the fracture healed and the pain was resolved. In those patients who complained of pain again, the biochemical markers of bone turnover had increased once more, and bone scintigraphy showed a new fracture at a different site. Because the changes in bone turnover markers were closely related to clinical symptoms of insufficiency fracture, we speculated that repeated measurements of bone turnover markers may be informative for discriminating insufficiency fracture from bone metastasis.