title: [Painful and swollen ankles: no arthritis].
abstract: A 53 year old male patient suffering from painful and swollen ankles showed a large enhancement on skeletal scintigraphy. The DXA bone density values for the neck of the femur and the lumbar vertebrae indicated severe osteoporosis. The conventional diagnostic x-ray revealed stress fractures of both distal tibiae (Looser's transformation zones). The patient had been treated with glucocorticoids for many years because of a liver transplantation. A further risk factor was impaired renal function with a hypovitaminosis D3 and secondary hyperparathyroidism.
authors.affiliation: Internistisch-Rheumatologische Gemeinschaftspraxis, Jürgensallee 44, 22609 Hamburg. reinhold-keller@rheuma-spezialisten.de
authors.forename: E
authors.initials: E
authors.lastname: Reinhold-Keller
authors.forename: R
authors.initials: R
authors.lastname: Wagner-Bastmeyer
mesh_terms: D000842:Ankle / Q000000981:diagnostic imaging*; D018771:Arthralgia / Q000000981:diagnostic imaging*; D001168:Arthritis / Q000175:diagnosis; D004487:Edema / Q000000981:diagnostic imaging*; D015775:Fractures, Stress / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging*