title: A case of early detection of bisphosphonate-related osteonecrosis of the jaw.
abstract: Osteonecrosis of the jaws is an adverse reaction associated with the use of bisphosphonates. Although the diagnosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is based on symptomatology, it is often detected late because the patients become symptomatic only after osteonecrosis is well established. We describe a case of early oral BRONJ detected by magnetic resonance imaging (MRI) accidentally. Head MRI revealed low signal of T1-weight images in left mandibula. Patient had been treated with minodronate for osteoporosis during 18 months. Based on the MRI findings and medication history, early stage BRONJ could be considered. Therefore minodronate was switched to teriparatide. Thereafter mandible pares-thesias, odontalgia and exposed bone were not observed. This case suggests that MRI is useful for the early detection of BRONJ.
authors.affiliation: Department of Pharmacy, Kuwana West Medical Center, Kuwana, Japan.
authors.forename: Miyu
authors.initials: M
authors.lastname: Mori
authors.affiliation: Department of Pharmacy, Kuwana West Medical Center, Kuwana, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Koide
authors.affiliation: Department of Orthopaedic Surgery, Kuwana West Medical Center, Kuwana, Japan.
authors.forename: Yuriyo
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: Department of Orthopaedic Surgery, Kuwana West Medical Center, Kuwana, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Matsuda
mesh_terms: D000368:Aged; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000175:diagnosis*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000627:therapeutic use; D004164:Diphosphonates / Q000009:adverse effects*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D019379:Teriparatide / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D019379:Teriparatide; C087958:YM 529
keywords: Magnetic resonance imaging; T1-weight images; minodronate; rheumatoid arthritis; teriparatide