The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Atypical Femoral Fracture in a Patient with Rheumatoid Arthritis

류마티스관절염 환자에서 발생한 비정형 대퇴골 골절의 1예

  • Kim, Dam (Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine) ;
  • Jung, Sodam (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Son, Chang-Nam (Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine) ;
  • Choi, Ji-Young (Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine) ;
  • Lee, Seunghun (Department of Radiology, Hanyang University College of Medicine) ;
  • Kim, Yee-Suk (Department of Orthoperdic Surgery, Hanyang University College of Medicine) ;
  • Sung, Yoon-Kyoung (Department of Rheumatology, Hospital for Rheumatic Diseases, Hanyang University College of Medicine)
  • 김담 (한양대학교 류마티스병원 류마티스내과) ;
  • 정소담 (한양대학교 의과대학 내과학교실) ;
  • 손창남 (한양대학교 류마티스병원 류마티스내과) ;
  • 최지영 (한양대학교 류마티스병원 류마티스내과) ;
  • 이승훈 (한양대학교 의과대학 영상의학과교실) ;
  • 김이석 (한양대학교 의과대학 정형외과학교실) ;
  • 성윤경 (한양대학교 류마티스병원 류마티스내과)
  • Received : 2013.08.26
  • Accepted : 2013.11.11
  • Published : 2014.08.01
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Abstract

Atypical femoral fractures are characterized by a subtrochanteric or diaphyseal location. Recent studies have suggested that long-term treatment with bisphosphonates might be associated with the occurrence of atypical femoral fractures. The present report describes a case involving a 60-year-old woman with left buttock pain that was unassociated with trauma. Her hip pain was initially considered to be a symptom of her underlying rheumatoid arthritis, but a plain radiography, bone scintigraphy, and magnetic resonance imaging revealed an insufficiency fracture in the lateral shaft of the left proximal femur. She had been treated with a bisphosphonate for 4.5 years because of a previous vertebral fracture. Her chronic, long-term rheumatoid arthritis and history of bisphosphonate administration were considered to be associated with the development of her atypical femoral fracture.

류마티스관절염 환자에서 질환 자체의 활성도나 질환으로 인한 비스포스포네이트의 장기간 사용 및 PPI, 스테로이드의 사용으로 비정형 대퇴골 골절의 위험도가 높아질 수 있으므로 비정형 대퇴골 골절에 대한 많은 연구가 필요하다고 생각하며 대퇴부 통증이 있는 경우 비정형 대퇴골 골절을 염두에 두고 면밀한 진찰과 영상진단을 해야 한다.

Keywords

References

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