PDF(Pubmed)
Abstract：
Paget\'s disease of bone (PDB) is a progressive bone disorder characterized by increased osteoclast-mediated bone resorption and abnormal bone formation. Incomplete atypical femoral fracture, appearing radiographically as a stress fracture at the lateral aspect of the femur, is an uncommon low-trauma fracture frequently seen in association with long-term bisphosphonate therapy. We describe the case of a 61-year-old female patient with PDB who developed a stress fracture at the lateral femoral cortex after 5 doses of intravenous bisphosphonate. The conservative treatment plan included discontinuation of bisphosphonate, a continuation of calcium and vitamin D supplementation, and limited weight-bearing for 3 months. The patient\'s pain level gradually improved after switching to the new treatment plan. At the latest follow-up, approximately 5 years after the initiation of conservative treatment, the patient remained pain-free, and her PDB was well-controlled. However, the fracture line was still visible on the most recent radiograph. Although it remains unclear whether a stress fracture at the lateral femoral cortex occurred due to bisphosphonate therapy or PDB, this case highlights the importance of careful evaluation of any lesion that appears in PDB patients receiving bisphosphonate therapy.
摘要：
Paget骨病(PDB)是一种进行性骨病,其特征是破骨细胞介导的骨吸收增加和骨形成异常。不完全非典型股骨骨折，影像学表现为股骨外侧的应力性骨折，是一种罕见的低创伤骨折，常见于长期双膦酸盐治疗。我们描述了一名61岁的PDB女性患者的病例，该患者在5剂静脉注射双膦酸盐后在股骨外侧皮质发生应力性骨折。保守治疗方案包括停用双膦酸盐,继续补充钙和维生素D，和有限的承重3个月。切换到新的治疗方案后，患者的疼痛程度逐渐改善。在最新的后续行动中，开始保守治疗大约5年后，病人仍然没有痛苦，她的PDB控制得很好。然而,在最近的X线片上仍然可以看到骨折线.尽管目前尚不清楚是由于双膦酸盐治疗还是PDB引起的股骨外侧皮质应力性骨折，该病例强调了仔细评估接受双膦酸盐治疗的PDB患者中出现的任何病变的重要性.
