title: A case of bilateral stress fractures in an old woman: three years of pain.
abstract: In elderly patients frequent episodes of joint pain of lower limbs exacerbated by stress and resistant to treatment occur frequently. This paper reports a case of a long lasting bilateral atraumatic knee pain with a final diagnosis of bilateral stress fractures of proximal tibia in osteoporotic postmenopausal woman. The distinctive trait of this case is that the fracture has set in bilaterally and associated with an isthmic L4-L5 spondylolisthesis in a patient afflicted by a decline in mood. This particular clinical picture has delayed the diagnosis and the suitable treatment for 3 years. Therapy for this type of patients must aim in the acute phase at pain relief and only after must be settled in a long term antiosteoporotic therapy. We choose clodronate acyd for pain relief and after strontium ranelate for osteoporosis prevention.
authors.affiliation: Orthopaedic Clinic, Unit II of Orthopaedics and Traumatology, University of Pisa, Pisa, Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Scaglione
authors.affiliation: Orthopaedic Clinic, Unit II of Orthopaedics and Traumatology, University of Pisa, Pisa, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Fabbri
authors.affiliation: Orthopaedic Clinic, Unit II of Orthopaedics and Traumatology, University of Pisa, Pisa, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Dell'Omo
authors.affiliation: Orthopaedic Clinic, Unit II of Orthopaedics and Traumatology, University of Pisa, Pisa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Gambini
authors.affiliation: Orthopaedic Clinic, Unit II of Orthopaedics and Traumatology, University of Pisa, Pisa, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Di Rollo
authors.affiliation: Orthopaedic Clinic, Unit II of Orthopaedics and Traumatology, University of Pisa, Pisa, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Guido
keywords: clodronic acid; knees; osteoporosis; spondilolistesys; stress fracture