Bilateral talar stress fractures in pregnancy-related osteoporosis: A rare case report

BackgroundStress fractures are categorized as fatigue or insufficiency fractures and are most frequently observed in athletes and military personnel. Their occurrence during pregnancy is rare, but pregnancy-related osteoporosis can predispose patients to insufficiency fractures.MethodWe report a rare case of bilateral talar stress fractures associated with pregnancy-related osteoporosis in a multiparous woman who presented with progressively worsening heel pain during late pregnancy and the postpartum period. Initial radiographs were inconclusive, prompting further evaluation with magnetic resonance imaging (MRI), which revealed bilateral talar stress fractures. Laboratory investigations assessing calcium metabolism and vitamin D levels supported metabolic bone involvement. Bone mineral density measurement using dual-energy X-ray absorptiometry (DEXA) confirmed pregnancy-related osteoporosis.ResultThe patient was managed conservatively with analgesics, calcium and vitamin D supplementation, and a structured physical therapy program. Gradual clinical improvement was observed, and symptoms resolved over a 1-2 year follow-up period without the need for surgical intervention.ConclusionThis case highlights the importance of considering stress fractures in pregnant and postpartum patients presenting with persistent heel pain. Early recognition, appropriate imaging, and metabolic evaluation are crucial for diagnosis. Conservative treatment can lead to favorable long-term outcomes. Increased awareness among healthcare providers is essential to avoid delayed diagnosis in this uncommon but significant condition.