title: Insufficiency fractures of the distal tibiae.
abstract: We describe two patients with uncommon types of insufficiency fractures that occurred at the distal tibiae. In case 1, a 71-year-old man with secondary osteoporosis due to hypogonadism fracture of his left distal tibia was overlooked because initial radiographs had seemed normal. However, bone scintigram obtained 2 months prior to the onset of fracture had already demonstrated abnormally high uptake at the site. In case 2, a 62-year-old woman with postmenopausal osteoporosis sustained an insufficiency fracture of the left distal tibia. Good clinical results were obtained with nonsurgical treatment. Based on the clinical course of case 1, we believe that bone scintigrams may be useful not only for the early diagnosis of insufficiency fracture but also for predicting such fractures.
authors.affiliation: Department of Orthopedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Miyakoshi
authors.forename: K
authors.initials: K
authors.lastname: Sato
authors.forename: H
authors.initials: H
authors.lastname: Murai
authors.forename: Y
authors.initials: Y
authors.lastname: Tamura
mesh_terms: D000368:Aged; D003951:Diagnostic Errors; D005260:Female; D015775:Fractures, Stress / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications; D011859:Radiography; D011877:Radionuclide Imaging; D013978:Tibial Fractures / Q000000981:diagnostic imaging* / Q000209:etiology