Bilateral Simultaneous Proximal Tibial Insufficiency Fractures in a Patient Suffering From Psoriatic Arthritis

Bilateral synchronous proximal tibia insufficiency fractures are rarely reported. We present a case of simultaneous proximal tibia bilateral insufficiency fractures in a 51-year-old female patient with underlying psoriatic arthritis, who was on chronic steroid medication. She reported sudden onset of bilateral knee pain after intense workout one week ago. Initial clinical and X-ray evaluation did not reveal significant pathology. Four weeks later, due to persistent pain in the absence of significant radiographic findings during follow-up, the patient was referred for MRI, which revealed fractures of both proximal tibias. A "mixed" treatment protocol was applied. In particular, this protocol included combination of rest and intermittent removable knee ranger braces immobilization with weight-bearing when applied. The patient went on to make a full recovery. Chronic inflammatory disorders accompanied by suspicious clinical manifestations should be thoroughly inspected. Diagnostic and treatment protocols should be further discussed and implemented.