Aged, 80 and over ; Bone Density Conservation Agents/adverse effects* ; Diphosphonates/adverse effects* ; Female ; Hip Fractures/diagnostic imaging* ; Hip Fractures/etiology ; Humans ; Jaw/diagnostic imaging ; Jaw/pathology ; Osteonecrosis/diagnostic imaging* ; Osteonecrosis/etiology ; Radionuclide Imaging
Keywords
bone scan ; bisphosphonate ; atypical ; fracture ; osteonecrosis of the jaw
Abstract
An 82-year-old woman presented with bilateral thigh pain. She had pain in her right thigh operated for a low-trauma fracture 2 years earlier and newly developed pain in her left thigh without trauma. A whole-body bone scan revealed increased tracer uptake in her bilateral subtrochanteric femoral shafts and in the right mandible without evidence of metastatic bone disease. She had been taking bisphosphonates for 7 years to treat osteoporosis and was soon diagnosed with atypical subtrochanteric fractures and bisphosphonate-related osteonecrosis of the jaw. The bone scan simultaneously identified 2 serious adverse effects of long-term use of bisphosphonates.