A protective role for vitamin K in bone health has been suggested based on its role as an enzymatic cofactor. In observational studies, vitamin K insufficiency is generally associated with lower bone mass and increased hip fracture risk. However, these findings are not supported in randomized controlled trials (RCT) of phylloquinone (vitamin K(1)) supplementation and bone loss at the hip in the...

Sternal metastases are not studied extensively in the literature. There is a paucity of information on their role in metastatic disease. The concept of the fourth column was described by Berg in 1993, and has been proven in case report, clinically and biomechanical studies. The role of the sternum as a support to the thoracic spine is well documented in the trauma patients, but not much is know...

INTRODUCTION Subchondral insufficiency fracture (SIF) of femoral head is not very common cause of hip pain. This usually occurs in elderly osteoporotic patients or fatigue fracture in young military recruits. CASE REPORT We report a case of hip pain in an osteoporotic male which was diagnosed on MRI after the condition was missed by two physicians initially. Patient responded well to conserva...

There have been recent reports linking alendronate and a specific pattern of subtrochanteric insufficiency fracture. We performed a retrospective review of all subtrochanteric fractures admitted to our institution between 2001 and 2007. There were 20 patients who met the inclusion criteria, 12 of whom were on long-term alendronate. Alendronate-associated fractures tend to be bilateral (Fisher's...

Hairy cell leukaemia (HCL) is a rare B non-Hodgkin lymphoma that commonly presents with cytopenias, splenomegaly and infection. We report 58-year-old man who presented acutely left hip pain. MRI scan identified pathological neck of femur fracture, along subacute sacral fracture. A total replacement was performed sent for histology which showed infiltration the bone surrounding tissue by monoton...

OBJECTIVE Increasing evidence suggests long-term alendronate use may overly suppress bone metabolism, limiting repair of microdamage and creating risk for insufficiency fractures. The purpose of this study is to demonstrate an association between alendronate use and a specific pattern of low-energy femoral shaft fracture. DESIGN, SETTING, AND PATIENTS A retrospective review was performed of p...

The sacrum bone is an integral part of the spinal column and pelvic ring. The lumbosacral neurologic function is protected by the sacrum and it maintains spinal column and pelvic alignment. For these reason, injuries to the sacrum may result in deformity, chronic pain and loss of lower extremity, bowel, bladder and sexual function. Therefore, the treatment of sacral fractures requires optimizin...

We report 2 cases of sacral insufficient fracture detected by FDG-PET/CT. In case 1, a 79-year-old female patient with malignant lymphoma, who had recent lumbago, received FDG-PET/CT examination. Vertical linear FDG uptake medial to bilateral sacro-iliac joint was observed on FDG-PET and a fracture line corresponding to FDG uptake was observed in bone window of CT images. In case 2, an 81-year-...

Stress fractures are considered as multifactorial overuse injuries occurring in 0.3%-0.8% of patients suffering from rheumatic diseases, with rheumatoid arthritis being the most common underlying condition. Stress fractures can be classified according to the condition of the bone affected as: 1) fatigue stress fractures occurring when normal bone is exposed to repeated abnormal stresses; and 2)...