title: Multiple insufficiency fractures with severe osteoporosis.
abstract: Multiple insufficiency fracture is a rare injury. We report a 63-year-old woman who spontaneously developed insufficiency fractures at multiple sites including ribs, sacrum, pubis, ischium, acetabulum, metatarsal bone, and femoral neck. The patient had severe osteoporosis with a bone mineral density of 0.267 g/cm(2), although there was no evidence of bone metabolic disease or metastatic bone tumor. Risk factors for osteoporosis in this case were her postmenopausal state and a history of gastrectomy. Interestingly, the serum level of insulin-like growth factor I, recognized as a growth factor that stimulates bone formation, was markedly decreased, and the patient had had viral hepatitis C. It was speculated that the synergistic effects of these disorders might have produced the osteoporosis, leading ultimately to the multiple insufficiency fractures.
authors.affiliation: Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo 060-8543, Japan.
authors.forename: Kousuke
authors.initials: K
authors.lastname: Iba
authors.forename: Takuro
authors.initials: T
authors.lastname: Wada
authors.forename: Junichi
authors.initials: J
authors.lastname: Takada
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yamashita
mesh_terms: D015897:Comorbidity; D005260:Female; D005598:Fractures, Spontaneous / Q000097:blood / Q000209:etiology*; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D036341:Intercellular Signaling Peptides and Proteins; C065700:myotrophin