title: Osteoporotic fractures and persistent non-fusion of the hand epiphyses caused by empty sella syndrome in an adult: a case report.
abstract: We report a case of primary empty sella syndrome (ESS) resulting in osteoporotic fractures and persistent non-fusion of the hand epiphyses, and discuss the potential pathogenesis of this disease. A 41-year-old man presented with pain in the right hand and back after a fall. X-radiographs revealed persistent epiphyses and severe osteoporosis. Serum phosphorus and prolactin levels were above normal levels, and free triiodothyronine, free thyroxine and testosterone levels were below normal limits. Magnetic resonance imaging of the head revealed empty sella. A lumbar bone mineral density examination indicated severe osteoporosis. ESS caused a systemic hormone disorder in this patient, resulting in osteoporotic fractures and persistent non-fusion of the hand epiphyses. Possible causes of this anomaly are chronic or congenital abnormities of the pituitary gland.
authors.affiliation: Department of Orthopaedics, Changzheng Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Xu
authors.forename: Hailong
authors.initials: H
authors.lastname: He
authors.forename: Yongfen
authors.initials: Y
authors.lastname: Chen
authors.forename: Ce
authors.initials: C
authors.lastname: Wang
authors.forename: Yunrong
authors.initials: Y
authors.lastname: Zhu
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Ye
mesh_terms: D000328:Adult; D004652:Empty Sella Syndrome / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D058866:Osteoporotic Fractures / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D010902:Pituitary Gland / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D011859:Radiography; D013739:Testosterone / Q000097:blood / Q000172:deficiency; D013974:Thyroxine / Q000097:blood / Q000172:deficiency; D014284:Triiodothyronine / Q000097:blood / Q000172:deficiency
chemical_list: D014284:Triiodothyronine; D013739:Testosterone; D013974:Thyroxine
keywords: Osteoporosis; empty sella syndrome; hyperprolactinaemia; hypogonadism; pituitary