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Case Reports
. 2022 Jul;111(1):96-101.
doi: 10.1007/s00223-022-00952-6. Epub 2022 Feb 8.

Bilateral Atypical Femur Fractures After Denosumab in a Bisphosphonate Naive Patient: A Case Report

Jeremy Keng Meng Goh  1 , Joyce Suang Bee Koh  2 , Alvin Choong Meng Ng  3 , Meng Ai Png  4 , Tet Sen Howe  2
Affiliations
Case Reports

Bilateral Atypical Femur Fractures After Denosumab in a Bisphosphonate Naive Patient: A Case Report

Jeremy Keng Meng Goh et al. Calcif Tissue Int. 2022 Jul.

Abstract

A case report of bilateral atypical femur fractures (AFF) in a bisphosphonate naive patient. A 62-year-old female bisphosphonate naive patient was started on denosumab for osteoporosis. Approximately 3 years later she complained of right hip pain and was found to have a bilateral incomplete AFFs. She was asymptomatic on the left lower limb. Patient was managed conservatively and placed on protected weight bearing on both legs. Symptoms subsequently resolved over a period of 3 months, although radiographic findings remained at approximately 1 year. AFFs may be associated with patients on denosumab therapy even without a prior history of bisphosphonate use. Patients should be counselled appropriately and monitored for such complications.

Keywords: Atypical femur fractures; Bisphosphonates; Denosumab; Osteoporosis; Prolia; Stress fractures.

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