Severe osteomalacia presenting as numerous fractures in late pregnancy (original) (raw)
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Acta orthopaedica Belgica, 2011
We present the case of a woman diagnosed with simultaneous displaced intracapsular femoral neck fractures following the birth of her second child. No traumatic event was identified. Diagnosis was delayed as the cause of her pain was thought to be non-skeletal in origin. Radiological and serological investigations were diagnostic of osteomalacia. Surgical fixation of her fractures was further delayed due to profound hypocalcaemia. Despite the delays, fixation with bilateral dynamic hip screws resulted in union with no evidence of avascular necrosis at 2 years follow-up. We believe this to be the first report of atraumatic bilateral femoral neck fractures and it shows that a good result can be achieved even in the presence of delayed fixation.
2016
Spontaneous pathological fractures of the pelvic bones and the femoral neck occuring during the last three months of pregnancy or immediately after delivery are often underestimated and misinterpreted. Early diagnosis and a prompt evaluation of symptoms and signs can prevent more serious orthopedical complications and physical limitations of the women in their family and work activities. We describe a recent clinical case under our observation 20 years after the pubblication of a previous report on the same subject.
Bilateral Hip Fractures Associated with Transient Osteoporosis of Pregnancy
Journal of the Royal Army Medical Corps, 2011
A case of transient osteoporosis of pregnancy complicated by bilateral neck of femur fractures is reported. We discuss the condition and review the literature, provide information to aid in the diagnostic dilemma clinicians may face when considering imaging techniques and the potential for foetal harm during radiation exposure. We discuss management strategies in such patients. CASE REPORT Figure 1: AP radiograph of the pelvis demonstrating bilateral femoral neck fractures. Figure 2: Postoperative AP radiograph of the pelvis following fixation of the fractures with cannulated hip screws.
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,