Bilateral osteonecrosis of the talus and "standing obsession" in a patient with anorexia nervosa.
We report a case of a 24-year-old woman with anorexia nervosa (AN), obsessive-compulsive disorder (OCD), and osteoporosis. During 8 years of illness, her body mass index (BMI) fluctuated between 10 and 13,5 kg/m(2). She developed hyperactivity and the habit to stand for all daily activities. She did not allow herself to sit at any time, she had "standing obsession." A few weeks after her admission to an inpatient unit for eating disorders, she reported pain in both ankles. Results and Discussion The rheumatological diagnosis was bilateral osteonecrosis of the talus and generalized osteoporosis. The latter and excessive biomechanical stress could be interpreted as the cause for this serious and irreversible bone destruction. The following case shows how the psychiatric comorbidity of a patient suffering from an eating disorder with a chronic course can lead to severe somatic complications.
Eating Disorders Unit, Psychiatric Outpatient Department, University Hospital, Culmannstr. 8, CH-8091 Zurich, Switzerland. gmilos@psyp.unizh.ch
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Milos
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Willi
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Häuselmann
D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000175:diagnosis; D010020:Osteonecrosis / Q000150:complications* / Q000175:diagnosis*; D013628:Talus / Q000473:pathology*