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Case Reports
. 2023 Sep 2;18(11):4048-4051.
doi: 10.1016/j.radcr.2023.08.040. eCollection 2023 Nov.

Bisphosphonate-induced atypical femoral shaft fracture: A case report

Ameer Mustafa Farrukh  1 , Ligia Carolina Flores Reyes  2 , Gabriela Sayonara Lopez Capa  3 , Tania Beatriz Marin Padilla  4 , Vyshnavidevi Sunkara  5 , Sandhya Dhakal  6
Affiliations
Case Reports

Bisphosphonate-induced atypical femoral shaft fracture: A case report

Ameer Mustafa Farrukh et al. Radiol Case Rep. .

Abstract

Osteoporosis is an important cause of fractures in postmenopausal women. Bisphosphonates are the first line of treatment for osteoporosis. However, long-term use of these medications has been related to atypical femoral fractures (AFF). We present a case of a 71-year-old postmenopausal woman, with a history of osteoporosis being treated with bisphosphonates for 6 years. The patient developed pain in her left hip and thigh over a period of 3-4 months. Radiographic studies showed an AFF and she was managed conservatively. Stopping bisphosphonate therapy should be an initial step in managing or limiting the progression of AFF. A drug holiday should be considered in patients who have been treated for more than 3-5 years to prevent AFFs. The risk of developing AFFs should never be ignored in this subset of patients.

Keywords: Atypical femoral fracture; Bisphosphonates; Imaging; Osteoporosis; Postmenopausal.

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Figures

Fig 1
Fig. 1
Left thigh X-ray showing focal lateral cortical thickening and breaking of the lateral cortex of the midshaft of the femur below the level of the trochanter.
See this image and copyright information in PMC

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