Author(s)

Chia-Jung Hu¹, Jenn-Huei Renn^1,2*, Shan-Wei Yang¹, Kai-Cheng Lin¹

¹Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung.
²College of Pharmacy and Health Care, Tajen University, Pingtung.

Objective: Bisphosphonates were accepted first line treatment for osteoporosis. Long-term bisphosphonate treatment has been reported to be complicated with osteonecrosis of jaw (ONJ) and atypical fracture of femur. It is proposed to be the result of impaired remodeling of minor injury of bone. An atypical fracture occurs on a patient received only 1.5 years of bisphosphonate treatment with continuous decreasing bone mineral density. Case Presentation: This is a 53-year-old female Taiwanese. She has rheumatoid arthritis and has received long-term glucocorticoid treatment. Continuous decrease of bone mineral density in the serial BMD examination after alendronate treatment can be found. Thigh pain occurs after only 1.5 years of bisphosphonate treatment and it progresses to atypical fracture. Conclusions: Atypical fracture can occur in patients receive only short-term bisphosphonate treatment even BMD is still decreased after bisphosphonate treatment. Autoimmune disease, glucocorticoid treatment, Asian and female may be the possible risk factors.

Atypical Fracture; Bisphosphonate; Rheumatoid Arthritis

C. Hu, J. Renn, S. Yang and K. Lin, "Atypical Femoral Fractures in a Patient with Continuous Decreasing BMD after Only 1.5 Years of Bisphosphonate Treatment," Open Journal of Rheumatology and Autoimmune Diseases, Vol. 4 No. 1, 2014, pp. 29-33. doi: 10.4236/ojra.2014.41004.