title: Co-occurrence of subchondral insufficiency fracture of the femoral head and contralateral femoral neck fracture in a rheumatic patient receiving steroid treatment.
abstract: 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.
authors.affiliation: Department of Orthopaedic Surgery, Kyushu Rosai Hospital, 1-3-1 Kuzuharatakamatsu, Kokuraminami-ku, Kitakyushu, 800-0296, Japan. keitamiya@jcom.home.ne.jp
authors.forename: Keita
authors.initials: K
authors.lastname: Miyanishi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Hara
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hamada
authors.forename: Masayuki
authors.initials: M
authors.lastname: Maekawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Tsurusaki
authors.forename: Taka-aki
authors.initials: TA
authors.lastname: Moro-oka
authors.forename: Yoshi
authors.initials: Y
authors.lastname: Kamo
authors.forename: Seiya
authors.initials: S
authors.lastname: Jingushi
authors.forename: Takehiko
authors.initials: T
authors.lastname: Torisu
mesh_terms: 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*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D011239:Prednisolone; D008727:Methotrexate