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Multiple ipsilateral femoral stress fractures in a patient taking denosumab for osteoporosis—a case report

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Abstract

Summary

This is the first report describing three ipsilateral femoral stress fractures in a patient taking denosumab.

Introduction

Multiple reports of atypical femur fractures (AFF) in patients receiving denosumab have emerged recently. Denosumab is an anti-resorptive agent approved for treatment of osteoporosis. It is a human monoclonal antibody which blocks osteoclast activation, maturation, and function.

Methods

This is a case report of a 74-year-old female patient who sustained three stress fractures of her left femur.

Results

The patient healed her fractures after intramedullary nailing of the femur and was able to return to her activities.

Conclusions

High index of suspicion is needed in any patient with osteoporosis on denosumab complaining of thigh or groin pain. Careful examination and radiographic studies of both femurs are warranted if AFF is discovered.

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Funding

No grants or industry support were utilized for this project.

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Authors and Affiliations

  1. Department of Orthopaedics, University of Illinois at Chicago, 835 S. Wolcott Avenue E-270 MSS MC 844, Chicago, IL, 60612-7342, USA

    H. I. Piponov

  2. Advocate Lutheran General Hospital, Park Ridge, IL, USA

    H. I. Piponov, J. M. Goldstein & G. M. Eisenberg

  3. Illinois Bone and Joint Institute, Morton Grove, IL, USA

    J. M. Goldstein & G. M. Eisenberg

Authors
  1. H. I. Piponov
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  2. J. M. Goldstein
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  3. G. M. Eisenberg
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Corresponding author

Correspondence to H. I. Piponov.

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Conflict of interest

Hristo Piponov, Jeffrey Goldstein, and Gerald Eisenberg declare that they have no conflict of interest.

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IRB approval is not required for single case reports at our institution.

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The patient has signed an informed consent allowing the authors to collect information and publish findings.

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Piponov, H.I., Goldstein, J.M. & Eisenberg, G.M. Multiple ipsilateral femoral stress fractures in a patient taking denosumab for osteoporosis—a case report. Osteoporos Int 31, 2263–2267 (2020). https://doi.org/10.1007/s00198-020-05499-6

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  • DOI: https://doi.org/10.1007/s00198-020-05499-6

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