title: Sternum insufficiency fracture presenting as acute chest pain: a case report and review of the literature.
abstract: The spine, pelvic bones and long bones of the lower extremities are common sites for insufficiency fractures. Cases of sternum insufficiency fractures have been rarely reported in an elderly patient. Insufficiency fracture tends to occur in bones with decreased mechanical strength. It tends to occur in elderly patients, especially in postmenopausal women, with underlying diseases. We describe a case of sternum insufficiency fracture in a patient with rheumatoid arthritis and systemic lupus erythematosus on long-term corticosteroid therapy diagnosed in an emergency setting. Sternum insufficiency fracture is a rare cause of chest pain. This case serves to remind the emergency physician to remain vigilant for other noncardiac and nontraumatic causes of chest pain. If diagnosed accurately, these patients can be discharged and treated as outpatients.
authors.affiliation: Singapore General Hospital, Singapore General Hospital, Singapore, Singapore. blkh@mail2world.com
authors.forename: Kuo Hung
authors.initials: KH
authors.lastname: Lin
authors.forename: R
authors.initials: R
authors.lastname: Ponampalam
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D001172:Arthritis, Rheumatoid / Q000150:complications; D002637:Chest Pain / Q000209:etiology*; D005260:Female; D005598:Fractures, Spontaneous / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications; D008875:Middle Aged; D013249:Sternum / Q000293:injuries*
chemical_list: D000305:Adrenal Cortex Hormones