UNASSIGNED: A 19-year-old female presented complaining of bilateral hip pain. On physical examination, there was tenderness on palpation of both thighs. Her workup was significant for anemia, a high level of creatinine, hypocalcemia, elevated alkaline phosphatase, and parathyroid hormone. A pelvis radiograph showed bilateral femur neck fracture. Considering her very young age, the metabolic derangements she had and to avoid exposing her to a major surgery, we treated her fractures by fixation using three cannulated screws on each side. We aimed to report this case as it is an unusual presentation of a previously undetected stage 5 chronic kidney disease (CKD) in a very young patient.
UNASSIGNED: Renal osteodystrophy due to CKD can present with spontaneous bilateral femur neck fracture. Physicians should have a high index of suspicion for this condition not to miss a chronic disease with multiple sequelae. Furthermore, these fractures carry a high risk of complications and mortality, so they should be addressed promptly.
■一名19岁女性主诉双侧髋部疼痛。在体检时,两个大腿触诊时都有压痛。她的检查对贫血很重要,高水平的肌酐,低钙血症,碱性磷酸酶升高,和甲状旁腺激素.骨盆X光片显示双侧股骨颈骨折。考虑到她很小的年龄,她的代谢紊乱,为了避免让她接受大手术,我们用两侧三颗空心螺钉固定治疗她的骨折。我们的目的是报告这种情况,因为这是一个非常年轻的患者中以前未发现的5期慢性肾脏疾病(CKD)的不寻常表现。
■CKD引起的肾性骨营养不良可表现为自发性双侧股骨颈骨折。医生应该高度怀疑这种情况,不要错过具有多种后遗症的慢性疾病。此外,这些骨折有很高的并发症和死亡风险,所以应该及时解决。