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Clinical Cases in Mineral and Bone Metabolism

Gloria Raffaetà, Francesca Falossi, Agnese Menconi, Chiara Genovesi, Maurizio Mazzantini, Vanna Bottai, Giulio Guido
The fragility vertebral fractures have a considerable impact on an individual's health-related quality of life due to pain, limitations in activity, social participation, altered mood and balance impairment. Physiotherapy interventions may have an important role in improving quality of life, balance and reducing the fracture risk in people with osteoporotic vertebral fractures. In literature there are only a few studies that examine exercise interventions in osteoporotic populations with vertebral fracture and few studies that examine the effects on balance with instrumental measurements...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Laila Ennazk, Ghizlane El Mghari, Nawal El Ansari
Primary hyperparthyrodism (PHPT) is a common endocrine disease. It results from an inappropriate parathyroid hormone (PTH) secretion relative to serum ionized calcium level. Clinical manifestation of severe PHPT include bone disease called osteitis fibrosa cystica which reflects an increase osteoclastic resorption and osteoblastic activity. This high bone turnover is responsible of the occurrence of osteoclastomas, also named "brown tumors" (1). Rarely, PHPT may occur in inherited forms with association to fibrous jaw tumor that are unrelated to hyperparathyroidism...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Jeyakantha Ratnasingam, Luqman Ibrahim, Sharmila Paramasivam, Lee Ling Lim, Alexander Tan Tong Boon, Shireene Vethakkan
BACKGROUND: Poliomyelitis survivors suffer from post-myelitic complications including osteoporosis that are often overlooked. METHODS: We report a case of a 49-year-old lady with history of poliomyelitis with resultant flaccid paralysis of the involved limb. RESULTS: The bone mineral density revealed asymmetrical severe osteoporosis in the poliomyelitic limb. Given the risk of falls and fractures, she was commenced on oral bisphosphonate therapy...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Alessandro Moghnie, Veronica Scamacca, Giovanni De Fabrizio, Roberto Valentini
Atypical femoral fractures are often associated with prolonged bisphosphonate use. The American Society for Bone and Mineral Research (ASBMR) has set the diagnosis criteria for atypical subtrochanteric and diaphyseal femoral fractures by classifying them according to their major and minor criteria. Prolonged bisphosphonate use is correlated with AFF, but the pathogenetic mechanism that causes this kind of fracture has not been defined yet. We describe simultaneous bilaterally femoral fractures in a 76-year-old woman...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Nikolaos Sampanis, Eleni Gavriilaki, Eleni Paschou, Asterios Kalaitzoglou, Sotirios Vasileiou
Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations. Herein we aimed at presenting an unique case of a young patient with late manifestations of parathyroid cancer and reviewing the relevant literature. A 45-year-old male patient presented in the Outpatient Clinic with an episode of nephrolithiasis. His personal medical history includes: recurrent episodes of nephrolithiasis, laminectomy in the cervical spine due to ossification of the cervical ligamentum flavum and surgical resection of a giant cell tumor of the brain...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Shrikant Somani, Narendra Kotwal, Vimal Upreti
Milk alkali syndrome has shown resurgence with increase in use of (prescription or non prescription) calcium supplements. Cases of iatrogenic vitamin D intoxication has also increased due to increasing use of high doses of injectable vitamin D formulations by physicians, surgeons, orthopaedicians, gynecologists and other specialties inadvertently. Here, we present an unusual case of a 17-year-old boy who presented with iatrogenic hypercalcemia as a result of combination of milk alkali syndrome with vitamin D intoxication despite being a case of hypoparathyroidism and concomitantly suffering from celiac disease...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Aamna Hassan, Madeeha Khalid, Saquib Khawar
Melorheostosis is a benign, noninheritable bone dysplasia characterized by its classic radiographic features of dense, flowing hyperostosis. It frequently affects one limb, usually the lower extremity and rarely the axial skeleton. A 26-year-old lady with obesity, polycystic ovarian syndrome and scalp dandruff presented with a long standing history of upper extremity pain and inability to adduct the arm completely. A Tc-99m MDP whole body and SPECT/CT scan performed for suspected fibrous dysplasia showed increased radiotracer uptake in densely sclerotic humeral and radial melorheostosis...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Edgar Alonso Cano-Torres, Arnulfo González-Cantú, Gabriela Hinojosa-Garza, Fernando Castilleja-Leal
Immobilization hypercalcemia is an uncommon diagnosis associated with increased bone remodeling disorders and conditions associated with limited movement such as medullar lesions or vascular events. Diagnosis requires an extensive evaluation to rule out other causes of hypercalcemia. This is a report of a woman with prolonged immobilization who presented with severe hypercalcemia. This case contributes to identification of severe hypercalcemia as a result of immobility and the description of bone metabolism during this state...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Eugenio Chiarello, Giuseppe Tedesco, Matteo Cadossi, Paola Capra, Silvio Terrando, Andrea Miti, Sandro Giannini
Fragility fractures of the femur are one of the major causes of morbidity and mortality worldwide. The incidence of new contralateral hip fractures in elderly osteoporotic patients ranges from 7 to 12% within 2 years after the first fracture. Secondary prevention can be divided in: pharmacological therapy based on the prescription of anti-osteoporotic drugs with different mechanism of action and non-pharmacological therapy which is based on modification of environmental risk factors, on a healthy diet with daily supplements of calcium and vitamin D and calcium and on the use of hip protectors...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Sameer Khalid Khan, Terence Savaridas, Jennifer S Hemers, Zouheir Maarouf, Jane M Orgee, Michael M Orr
We present 2 cases of elderly females presenting with atraumatic, near-vertical (Pauwells grade 3), intracapsular neck of femur fractures. Following diagnosis of osteoporosis on DEXA scans, they had received alendronic acid for 7 and 10 years respectively. Routine blood tests and serum estimations of calcium, vitamin-D and thyroid-stimulating hormone, done at admission, were within the normal ranges. These patients were managed with a hemiarthroplasty and a dynamic hip screw (DHS) respectively, following discontinuation of bisphosphonates...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Chiara Schiraldi, Antonietta Stellavato, Francesca de Novellis, Annalisa La Gatta, Mario De Rosa
Osteoarthritis (OA) represents a group of chronic, painful, disabling conditions affecting synovial joints. It is characterized by degeneration of articular cartilage, alterations of peri-articular and subchondral bone, low-grade synovial inflammation (synovitis). Despite OA is commonly described as a non-inflammatory disease, it is known that its progression and the subsequent increment of symptoms correlate to the production of inflammatory factors that induce the secretion of enzymes responsible for cartilage degradation...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Alfredo Nardi, Lorenzo Ventura, Luisella Cozzi, Greta Tonini
Clodronate belongs to Bisphosphonates family and it has been studied especially for osteoporosis treatment, Paget's disease, osteolytic metastases, hypercalcemia malignancy and some childhood skeletal diseases. Besides the osteoporosis treatment, it has been successfully used for treating tumoral osteolysis and for bone localization of multiple myeloma, hypercalcemia malignancy, primary hyperparathyroidism, Paget's disease and algodystrophy. Filipponi study showed a statistically significant reduction of the incidence of vertebral fractures after 4 years of treatment with clodronate, intravenously administered at a dose of 200 mg every three weeks...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Thomas Baum, Dimitrios C Karampinos, Vanadin Seifert-Klauss, Tsvetelina D Pencheva, Pia M Jungmann, Ernst J Rummeny, Dirk Müller, Jan S Bauer
PURPOSE: Treatment with aromatase inhibitor (AI) is recommended for post-menopausal women with hormone-receptor positive breast cancer. However, AI therapy is known to induce bone loss leading to osteoporosis with an increased risk for fragility fractures. The purpose of this study was to investigate whether changes of magnetic resonance (MR)-based trabecular bone microstructure parameters as advanced imaging biomarker can already be detected in subjects with AI intake but still without evidence for osteoporosis according to dual energy X-ray absorptiometry (DXA)-based bone mineral density (BMD) measurements as current clinical gold standard...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Junichi Takada, Satoshi Ikeda, Tetsuya Kusanagi, Satoshi Mizuno, Hiroshi Wada, Kousuke Iba, Takashi Yoshizaki, Toshihiko Yamashita
OBJECTIVE: This study analyzes whether concomitant raloxifene (RLX) or bisphosphonates (BP) plus eldecalcitol (ELD) has excessive suppressive effects on a bone resorption marker during the first 6 months of treatment in postmenopausal women in real-world setting. METHODS: 285 postmenopausal osteoporotic patients who had been treated with RLX or BP plus ELD were evaluated the bone resorption marker, serum tartrate resistant acid phosphatase-5b (TRACP-5b), during the first 6 months of treatment...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Motoyuki Horii, Hiroyoshi Fujiwara, Yasuo Mikami, Takumi Ikeda, Keiichiro Ueshima, Kazuya Ikoma, Toshiharu Shirai, Masateru Nagae, Yoshinobu Oka, Koshiro Sawada, Nagato Kuriyama, Toshikazu Kubo
BACKGROUND: The incidence of femoral neck and trochanteric fractures reportedly differ by age and regionality. We investigated differences in monthly variations of the occurrence of femoral neck and trochanteric fractures as well as place and cause of injury in the Kyoto prefecture over a 6-year period. METHODS: Fracture type (neck or trochanteric fracture), age, sex, place of injury, and cause of injury were surveyed among patients aged ≥ 65 years with hip fractures that occurred between 2008 and 2013 who were treated in 1 of 13 participating hospitals (5 in an urban area and 8 in a rural area)...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Mohammad Shafi Kuchay, Sunil Kumar Mishra, Khalid Jamal Farooqui, Beena Bansal, Jasjeet Singh Wasir, Ambrish Mithal
Hypercalcemia caused by advanced chronic liver disease (CLD) without hepatic neoplasia is uncommonly reported and poorly understood condition. We are reporting two cases of advanced CLD who developed hypercalcemia in the course of the disease. This diagnosis of exclusion was made only after meticulous ruling out of all causes of hypercalcemia. The unique feature of this type of hypercalcemia is its transient nature that may or may not require treatment. This clinical condition in patients with CLD should be kept in mind while evaluating the cause of hypercalcemia in them...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Stefano Giannotti, Vanna Bottai, Giacomo Dell'Osso, Giulia Bugelli, Fabio Celli, Niki Cazzella, Giulio Guido
The algodystrophy, also known as complex regional pain syndrome (CRPS), is a painful disease characterized by erythema, edema, functional impairment, sensory and vasomotor disturbance. The diagnosis of CRPS is based solely on clinical signs and symptoms, and for exclusion compared to other forms of chronic pain. There is not a specific diagnostic procedure; careful clinical evaluation and additional test should lead to an accurate diagnosis. There are similar forms of chronic pain known as bone marrow edema syndrome, in which is absent the history of trauma or triggering events and the skin dystrophic changes and vasomotor alterations...
January 2016: Clinical Cases in Mineral and Bone Metabolism
Maria Luisa Brandi
No abstract text is available yet for this article.
January 2016: Clinical Cases in Mineral and Bone Metabolism
Mihir Desai, Sambprasad Nadkarni
We report a case of a patient who presented with inability to walk for 2 days which was acute in onset, with no history or preceeding trauma. On examination it was found to have stable vitals. Both lower limbs were in the flexed, abducted & externally rotated attitude, with no sensory motor deficit. Radiological investigations revealing osteoporosis and bilateral fracture neck of femur and blood investigations indicated severe vitamin D deficiency.
September 2015: Clinical Cases in Mineral and Bone Metabolism
Iñigo Etxebarria-Foronda, Pedro Carpintero
So-called atypical fractures have been related to prolonged treatment with bisphosphonates. Although there remain unanswered questions with respect to their etiology and physiopathology, it does appear to be a causal relationship. There are many references in the literature about this problem in patients in whom these drugs have been used to treat osteoporosis, but few reports in patients who have received this therapy for the management of osteogenesis imperfecta. The Authors describe a case of a young male patient with osteogenesis imperfecta with a number of historical fractures, and who received treatment with these drugs, initially parenterally and subsequently orally, presenting as a complication of the treatment, an atypical diaphyseal femoral fracture...
September 2015: Clinical Cases in Mineral and Bone Metabolism
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