title: Alendronate-related femoral diaphysis fracture--what should be done to predict and prevent subsequent fracture of the contralateral side?
abstract: BACKGROUND
  Atypical fractures of the femoral diaphysis have recently been associated with alendronate therapy (Neviaser et al. J Orthop Trauma 22(5):346-350, 2008; Kwek et al. Injury 39:224-231, 2008; Lenart et al. N Engl J Med 358:1304-1306, 2008).
  
  
  METHODS
  In many cases, fractures have occurred bilaterally prompting debate regarding appropriate screening of the unaffected side (Kwek et al. N Engl J Med 359(3):316-317, 2008).
  
  
  METHODS
  We report a case of sequential, bilateral, femoral diaphysis fractures associated with prolonged alendronate therapy and the failure to predict the subsequent fracture of the contralateral side despite radiological imaging.
  
  
  CONCLUSIONS
  We review the current literature and discuss potential management strategies.
authors: Rheumatology Department, Queen Alexandra Hospital, Portsmouth, Hampshire, UK. mhedwards@doctors.org.uk
authors: M H
authors: MH
authors: Edwards
authors: F C
authors: FC
authors: McCrae
authors: S A
authors: SA
authors: Young-Min
mesh_terms: D019386:Alendronate / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D005260:Female; D005264:Femoral Fractures / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology / Q000517:prevention & control; D015775:Fractures, Stress / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000517:prevention & control; D006801:Humans; D008875:Middle Aged; D011859:Radiography
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate