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Paradoxical Stress Fracture in a Patient With Multiple Myeloma and Bisphosphonate Use.
- Source :
-
Cureus [Cureus] 2020 Aug 18; Vol. 12 (8), pp. e9837. Date of Electronic Publication: 2020 Aug 18. - Publication Year :
- 2020
-
Abstract
- Multiple myeloma (MM) is a plasma cell disorder with related organ dysfunction, including hypercalcemia, renal insufficiency, anemia, and bone disease. Osteolytic bone lesions that result in pain and pathologic fractures are a major source of morbidity and the use of bisphosphonates is generally safe and effective treatment in reducing myeloma-related skeletal fractures and associated morbidity. We present a 73-year-old African American woman with MM in remission and on intravenous (IV) bisphosphonate therapy in the past five years who reported gradually worsening bilateral thigh pain of six months duration. A bone survey showed no neoplastic focus, and bilateral hip X-rays showed incomplete insufficiency stress fractures with characteristic features suspicious for bisphosphonate-related atypical femoral fracture (AFF). Increasingly reported in the literature, bilateral AFF is a unique and serious adverse effect for patients on bisphosphonates. Our case illustrates the distinct challenges in managing a patient with MM on long-term bisphosphonate therapy who suffered bilateral atypical femoral fractures, an uncommon presentation of a relatively rare phenomenon. It is important to balance the established benefits of bisphosphonate therapy with potential fracture risk and be particularly vigilant about adverse effect monitoring and timely intervention.<br />Competing Interests: The authors have declared that no competing interests exist.<br /> (Copyright © 2020, Chiu et al.)
Details
- Language :
- English
- ISSN :
- 2168-8184
- Volume :
- 12
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Cureus
- Publication Type :
- Report
- Accession number :
- 32953344
- Full Text :
- https://doi.org/10.7759/cureus.9837