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Bilateral tibial stress fracture in a young man due to hypercalciuric osteoporosis: a case report

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Abstract

Osteoporosis is commonly thought of as a disease of postmenopausal women, and older men have a lower risk of fracture than women. A stress fracture is an overuse injury and an important cause of disability in the athletic population. Presented here is a 30-year-old healthy man with pain on the anterior surface of the bilateral tibia. He did not communicate any trauma or overuse activity. The neurologic and locomotor system examinations were normal. Radiological examinations revealed tibial stress fractures in both left and right tibia and he had low bone mineral density. Routine hematological tests, bone resorption and formation markers were normal, except for hypercalciuria. After analyzing the results of these tests, the patient was diagnosed with bilateral tibial stress fractures due to hypercalciuric secondary osteoporosis. Osteoporosis should be considered in the differential diagnosis of atraumatic insufficiency fractures, especially in young healthy adults.

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References

  1. Consensus Development Panel on Osteoporosis (2001) JAMA 14 285(6):785–795

  2. Weiss M, Ben-Shlomo AB, Hagag P, Rapoport M (2000) Reference database for bone speed of sound measurement by novel quantitative multi-site ultrasound device. Osteoporos Int 11:688–696

    Article  PubMed  CAS  Google Scholar 

  3. Tannirandorn P, Epstein S (2000) Drug-induced bone loss. Osteoporos Int 11:637–659

    Article  PubMed  CAS  Google Scholar 

  4. Rea JA, Li J, Blake GM, Steiger P, Genant HK, Fogelman I (2000) Visual assessment of vertebral deformities by X-ray absorptiometry: a highly predictive method to exclude vertebral deformity. Osteoporos Int 11:660–668

    Article  PubMed  CAS  Google Scholar 

  5. Kanis JA, Johnell O, Oden A, Sernbo I, Redlund-Johnell I, Dawson A, De Laet C, Jonsson B (2000) Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 11:669–674

    Article  PubMed  CAS  Google Scholar 

  6. Bilezikian JP (1999) Osteoporosis in men. J Clin Endocrinol Metab 84:3431–3434

    Article  PubMed  CAS  Google Scholar 

  7. Marder RA (1988) Stress Fractures. In: Chapman MW (ed) Operative Orthopaedics, 2nd Edn. J.B. Lippincolt Company, Philadelphia, pp 373–377

    Google Scholar 

  8. Orwoll ES, Klein RF (1996) Osteoporosis in Men. In: Marcus R, Feldman D, Kelsey J (eds) Osteoporosis. Academic Press, San Diego, pp 745–784

    Google Scholar 

  9. Kelepouris N, Harper KD, Gannon F, Kaplan FS, Haddad JG (1995) Severe osteoporosis in men. Ann Intern Med 15 123(6):452–460

    CAS  Google Scholar 

  10. Pietschmann F, Breslau NA, Pak CY (1992) Reduced vertebral bone density in hypercalciuric nephrolithiasis. J Bone Miner Res 7(12):1383–1388

    Article  PubMed  CAS  Google Scholar 

  11. Zerwekh JE, Sakhaee K, Breslau NA, Gottschalk F, Pak CY (1992) Impaired bone formation in male idiopathic osteoporosis: further reduction in the presence of concomitant hypercalciuria. Osteoporos Int 2(3):128–134

    Article  PubMed  CAS  Google Scholar 

  12. Adams JS, Song CF, Kantorovich V (1999) Rapid recovery of bone mass in hypercalciuric, osteoporotic men treated with hydrochlorothiazide. Ann Intern Med 130:658–660

    PubMed  CAS  Google Scholar 

  13. Seeman E, Melton LJ 3rd, O’Fallon WM, Riggs BL (1983) Risk factors for spinal osteoporosis in men. Am J Med 75(6):977–983

    Article  PubMed  CAS  Google Scholar 

  14. Krauss MD, Van Meter CD (1994) A longitudinal tibial stress fracture. Orthop Rev 23(2):163–166

    PubMed  CAS  Google Scholar 

  15. Miyakoshi N, Sato K, Murai H, Tamura Y (2000) Insufficiency fractures of the distal tibiae. J Orthop Sci 5(1):71–74

    Article  PubMed  CAS  Google Scholar 

  16. Schultz E (1990) Case report 624. Stress fracture of distal portion of tibia associated with previously incurred gross fracture of more proximal segment of tibia. Skeletal Radiol 19(5):391–393

    Article  PubMed  CAS  Google Scholar 

  17. Clemetson IA, Popp A, Lippuner K, Ballmer F, Anderson SE (2004) Postpartum osteoporosis associated with proximal tibial stress fracture. Skeletal Radiol 33(2):96–98

    Article  PubMed  CAS  Google Scholar 

  18. Schmid L, Pfirrmann C, Hess T, Schlumpf U (1999) Bilateral fracture of the sacrum associated with pregnancy: a case report. Osteoporos Int 10(1):91–93

    Article  PubMed  CAS  Google Scholar 

  19. Rousiere M, Kahan A, Job-Deslandre C (2001) Postpartal sacral fracture without osteoporosis. Joint Bone Spine 68(1):71–73

    Article  PubMed  CAS  Google Scholar 

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Author notes

  1. Demet Ofluoglu

    Present address: Soyak Yenisehir Palmiye Evleri, C3 Blok D: 37, 34770, Umraniye/Istanbul, Turkey

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Physiatrist, Marmara University School of Medicine, Istanbul, Turkey

    Demet Ofluoglu & Gulseren Akyuz

  2. Department of Orthopedic Surgery and Traumatology, Orthopedic surgeon, Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey

    Onder Ofluoglu

Authors
  1. Demet Ofluoglu
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  2. Onder Ofluoglu
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  3. Gulseren Akyuz
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Correspondence to Demet Ofluoglu.

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Ofluoglu, D., Ofluoglu, O. & Akyuz, G. Bilateral tibial stress fracture in a young man due to hypercalciuric osteoporosis: a case report. Rheumatol Int 26, 469–472 (2006). https://doi.org/10.1007/s00296-005-0026-y

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  • DOI: https://doi.org/10.1007/s00296-005-0026-y

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