title: Bilateral tibia and fibula fractures in a patient with rheumatoid arthritis.
abstract: A 52-year-old woman with rheumatoid arthritis treated with low-dose steroids developed bilateral distal tibia and fibula fractures over a 15-month period. Her bone density was within osteopenic levels. Such fractures are an unusual but increasingly recognised complication of rheumatoid disease and its treatment, although there is often diagnostic delay. Bilateral fractures are particularly rare. A high level of clinical suspicion is required for early diagnosis.
authors.affiliation: Department of Rheumatology, Frimley Park Hospital. Frimley, Surrey, UK. mark@lloyd6236.freeserve.co.uk
authors.forename: M E
authors.initials: ME
authors.lastname: Lloyd
authors.forename: S
authors.initials: S
authors.lastname: Davitt
authors.forename: J R
authors.initials: JR
authors.lastname: Hall
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000843:Ankle Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D015519:Bone Density; D002370:Casts, Surgical; D003720:Densitometry; D004305:Dose-Response Relationship, Drug; D015914:Estrogen Replacement Therapy; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries*; D005500:Follow-Up Studies; D005598:Fractures, Spontaneous / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D010147:Pain Measurement; D011859:Radiography; D018570:Risk Assessment; D013978:Tibial Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy
chemical_list: D000305:Adrenal Cortex Hormones