Severe osteomalacia presenting as numerous fractures in late pregnancy (original) (raw)
Bilateral femoral neck fractures due to transient osteoporosis of pregnancy: a case report
Cases Journal, 2008
We describe a case of bilateral femoral neck fractures secondary to transient osteoporosis of pregnancy, which were diagnosed after delivery due to the desire to avoid ionising radiation. These fractures were presumed to be secondary to transient osteoporosis of pregnancy and were treated successfully with internal fixation despite delayed presentation. We discuss the role of MRI in the evaluation of hip pain in pregnancy.
Background: Pregnancy-associated osteoporosis (PAO) is a rare condition characterized by reduced bone mineral density during the third trimester or lactation. Multiple risk factors, such as genetic, sedentariness, and 25-hydroxy vitamin D deficiency, are associated with PAO. In the majority of cases, PAO is presented with a compression fracture in vertebras, but in our case, it presented with a fracture of the femoral neck. Case Presentation: A 29-year-old, gravida one woman, developed right hip joint pain during the gestational age 34 weeks who referred to our clinic. Despite conservative management, the pain intensified. The patient delivered a healthy neonate in the 38th week of gestation and afterward underwent magnetic resonance imaging of the pelvic, revealing a bruised bone in the femoral neck. Since she had developed a femoral neck fracture during the postpartum period, she underwent open reduction and fixation of the femoral neck. Dual-energy X-ray absorptiometry (DEXA) revealed osteoporosis of the vertebras and femoral neck. She received calcium supplements and alendronate, and the pain was relieved. On 2-year and 4-year follow-up, she was found to be osteopenic with significant improvement in DEXA indices. Conclusion: PAO is a rare condition among young women. This condition should be kept in mind when hip joint or back pain is encountered during pregnancy.
Galen Medical Journal, 2020
Background: Pregnancy-associated osteoporosis (PAO) is a rare condition characterized by reduced bone mineral density during the third trimester or lactation. Multiple risk factors, such as genetic, sedentariness, and 25-hydroxy vitamin D deficiency, are associated with PAO. In the majority of cases, PAO is presented with a compression fracture in vertebras, but in our case, it presented with a fracture of the femoral neck. Case Report: A 29-year-old, gravida one woman, developed right hip joint pain during the gestational age 34 weeks who referred to our clinic. Despite conservative management, the pain intensified. The patient delivered a healthy neonate in the 38th week of gestation and afterward underwent magnetic resonance imaging of the pelvic, revealing a bruised bone in the femoral neck. Since she had developed a femoral neck fracture during the postpartum period, she underwent open reduction and fixation of the femoral neck. Dual-energy X-ray absorptiometry (DEXA) revealed ...
BMJ Case Reports, 2021
Transient osteoporosis of the hip (TOH) is a rare cause of pelvic pain in the third trimester of pregnancy and post partum. Although several cases have been reported in literature, its aetiology is poorly understood. The diagnosis is commonly missed in pregnancy, as the presenting symptoms can be vague, and the risks of radiographic imaging deter clinicians from pursuing investigation. In extreme cases, this pathology presents with neck of femur fractures, with no current guidelines on optimal management. We describe the case of a 24-year-old woman who presented with bilateral neck of femur fractures at 34 weeks gestation. Following an emergency caesarean section, operative management consisted of bilateral closed reduction and internal fixation using dynamic hip screws. Postoperative radiographs demonstrated failure of fixation on the left side, which was revised to a complex primary arthroplasty. This case demonstrates both the diagnostic and management challenges associated with ...
A Not So Transient “Transient Osteoporosis” of the Spine in Pregnancy
Clinical Case Reports: Open Access, 2021
Transient Osteoporosis of Pregnancy was first described in 1958 by Curtiss and Kincaid after evaluation of three pregnant patients with painful hips during their third trimester [1]. It is a rare potential complication of pregnancy which unexpectedly affects young, healthy women with a previously uneventful pregnancy [2]. The most commonly affected area is the femoral neck, but it can also involve the shoulder, knee, and ankle [3]. The diagnosis is one of exclusion with the commonest differential diagnoses being a joint infection, rheumatoid arthritis, avascular necrosis of femoral head, pigmented villonodular synovitis,
Osteoporosis in pregnancy: a case report and review of the literature
Acta Medica Mediterranea, 2014
Osteoporosis is a skeletal disorder characterized by an impairment of bone strength, associated with high risk of fractures. Usually it affects women over 50 years, both due to menopause and aging. A rare form of osteoporosis is the one associated with pregnancy and lactation. Here we present the case of a young woman who developed a severe vertebral and femoral osteoporosis after pregnancy and during lactation. This patient came to our observation after the onset of lumbar back pain associated with severe functional limitation, so that she was not able to walk. First instrumental investigations showed a vertebral fracture and a remarkably reduced bone mineral density (BMD), both of the rachis (total T score:-5.3 SD; Z score: -5.1 SD) and of the hip (total T score: -3.5 SD; Z score: -3.5 SD). During the two years follow-up the patient has been treated with bisphosphonates, vitamin D ad calcium, and has shown an improvement of clinical condition and a significant recovery of BMD.
Journal of orthopaedic surgery (Hong Kong), 2012
Transient osteoporosis during pregnancy is a rare, self-limiting disease. We report on a 36-year-old woman who had bilateral subcapital femoral neck fractures during the 6th month of pregnancy. The diagnosis was made 4 days after delivery, because radiography was declined by the patient for fear of radiation. Fixation was not feasible owing to bone resorption, and 2-stage bipolar hemiarthroplasty was therefore performed. Magnetic resonance imaging is the best non-invasive investigative tool for pregnant women with hip pain. Early detection can prevent complications and resorting to major surgeries.
Displaced subcapital fracture of the hip in transient osteoporosis of pregnancy
International Orthopaedics, 1997
We describe a case of displaced subcapital fracture of the hip in a woman in the third trimester of her first pregnancy. A pathological fracture occurred in a previously painful hip, and radiographs showed pronounced osteopenia of the femoral head and neck. Closed reduction and internal fixation was carried out 2 weeks after delivery when the osteopenia was still severe. Healing of the fracture followed with recovery of hip movements.
Neglected Femoral Neck Fracture Associated with Pregnancy: Case Report
Journal of Academic Research in Medicine
Transient osteoporosis is a self-limiting condition mostly seen in third trimester of pregnancy. MRI is a noninvasive method for the diagnosis of transient osteoporosis in pregnancies with hip and pelvic pain. We present a 28-year-old primipar with a 3-month history of left hip pain one month after delivery. Garden type 3 fracture was detected. The patient underwent intertrochanteric valgus osteotomy and osteosynthesis. Twenty months of follow-up did not reveal any complications such as nonunion or AVN. In the case of hip pain in pregnancy, the diagnosis of transient osteoporosis with MRI can be made early and more serious complications can be avoided. Successful results can be obtained with intertrochanteric valgus osteotomy in the treatment of neglected femur neck fracture in young patients.