Co-occurrence of subchondral insufficiency fracture of the femoral head and contralateral femoral neck fracture in a rheumatic patient receiving steroid treatment.
We describe a 79-year-old woman with rheumatoid arthritis who suffered from subchondral insufficiency fracture of the femoral head (SIF) and contralateral femoral neck fracture. Radiographs obtained two months after the onset of thigh pain showed collapse of the right femoral head and contralateral femoral neck fracture. MRI revealed a subchondral serpiginous low-intensity band in the right femoral head on the T2-weighted image. This case report suggests that SIF should be considered in the differential diagnoses of rheumatic patients who suffer from thigh pain without antecedent trauma.
Miyanishi
Keita
K
Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-3-1 Kuzuharatakamatsu, Kokuraminami-ku, Kitakyushu, 800-0296, Japan. keitamiya@jcom.home.ne.jp
Hara
Toshihiko
T
Hamada
Tetsuo
T
Maekawa
Masayuki
M
Tsurusaki
Susumu
S
Moro-oka
Taka-aki
TA
Kamo
Yoshi
Y
Jingushi
Seiya
S
Torisu
Takehiko
T
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications / Q000473:pathology*; D005270:Femur Head / Q000293:injuries*; D015775:Fractures, Stress / Q000209:etiology / Q000473:pathology*; D006620:Hip Fractures / Q000150:complications / Q000473:pathology*; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008727:Methotrexate / Q000627:therapeutic use; D010020:Osteonecrosis / Q000175:diagnosis; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011239:Prednisolone; D008727:Methotrexate