JaLCDOI 10.18926/AMO/56253
FullText URL 72_5_531.pdf
Author Kondo, Naoki| Fujisawa, Junichi| Arai, Katsumitsu| Kakutani, Rika| Endo, Naoto|
Abstract A 60-year-old Japanese woman with severe osteoporosis presented with a history of right buttock pain and right lateral lower leg pain in an L5 distribution. She had been treated with methotrexate and methylprednisolone for rheumatoid arthritis (RA) and interstitial pneumonia. Computed tomography demonstrated a sacral stress fracture in the right sacral ala. The right L5 nerve root was compressed by the fracture site. This case is rare in that L5 radiculopathy was complicated by a sacral stress fracture. Clinicians should suspect sacral stress fractures when RA or osteoporosis is present in women who experiences lumbar pain and lumbar radiculopathy.
Keywords lumbar 5 radiculopathy sacral stress fracture osteoporosis rheumatoid arthritis
Amo Type Case Report
Published Date 2018-10
Publication Title Acta Medica Okayama
Volume volume72
Issue issue5
Publisher Okayama University Medical School
Start Page 531
End Page 534
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 30369612
JaLCDOI 10.18926/AMO/56252
FullText URL 72_5_525.pdf
Author Kakutani, Rika| Kondo, Naoki| Mochizuki, Tomoharu| Fujisawa, Junichi| Endo, Naoto|
Abstract The bilateral shoulder pain of an 81-year-old Japanese woman due to falls persisted despite celecoxib treatment, and plain X-rays later showed bilateral collapsed humeral heads. After ruling out osteoarthritis, infectious arthritis, crystal-induced arthritis, neuropathic arthropathy, and osteonecrosis, we diagnosed bilateral shoulder joint rapidly destructive arthrosis (RDA). Lumbar bone mineral density showed very low T-score (−4.1). Primary osteoporosis was observed. Histology of biopsied humeral head indicated the features of fracture healing process: callus formation and osteoclasts without empty lacunae. Her history thus included an insufficiency fracture due to severe osteoporosis. Bilateral humeral head replacement was performed; her shoulder joint function improved. This case is extremely rare in that RDA was caused by simultaneous bilateral shoulder joint collapse within a very short time, with minimal or low mechanical stress and severe osteoporosis.
Keywords rapidly destructive arthrosis differential diagnosis humeral head replacement osteoporosis shoulder joint
Amo Type Case Report
Published Date 2018-10
Publication Title Acta Medica Okayama
Volume volume72
Issue issue5
Publisher Okayama University Medical School
Start Page 525
End Page 530
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 30369611