Hiperparatroidili bir Hastada Pubik ve sakral Yetmezlik Kırığı: Olgu sunumu

Year 2014, Volume: 2 Issue: 2, 65 - 68, 12.07.2016

Ferhat Gökmen Yılmaz Savaş Erkam Kömürcü Betül Kızıldağ Yusuf Ziya Tan

Abstract

Yetmezlik kırıkları direnci azalmış kemiğe uygulanan normal veya fizyolojik bir stresin sonucu gelişen stres kırığının bir alt tipidir. Bu kırıklar kemiğin elastisitesinin veya mineral içeriğinin anormal olduğu birçok durumda ortaya çıkar. Yetmezlik kırığının en sık görülen sebebi postmenopozal osteoporozdur. Diğer önemli nedenler senil osteoporoz, osteomalazi, hiperparatroidi, radyasyon uygulanması, kortikosteroid tedavisi ve romatoid artrittir. Yetmezlik Kırığı ciddi kasık, kalça ağrısı ve güçsüzlüğü olan postmenopozal kadınlarda akla gelmelidir. Bu yazıda hiperparatroidisi olan bir hastada üst ve alt pubik ramusun yetmezlik kırığı ile birlikte sakral yetmezlik kırığı bulunan olgunun klinik ve radyolojik bulguları sunulmuştur.

Keywords

Yetmezlik kırığı, hiperparatroidi

Pubic and Sacral Insufficiency Fracture in a Patient with Hyperparathyroidism

Abstract

Insufficiency fractures are subtype of stres fractures which occur when normal or physiological stresses are placed on weakened bone. These fractures occur in a variety of conditions in which the mineral content or the elasticity of bone is abnormal. The most common cause of insufficieny fracture is postmenopausal osteoporosis. The other important causes are, senile osteoporosis, osteomalacia, hyperparathyroidism, irradiation, corticosteroid treatment and rheumatoid arthritis. Insufficiency fracture should be suspected in a postmenopausal women presenting with severe groin and buttock pain and weakness. We presented here the clinical and radiological findings of Sacral insufficiency together superior and inferior pubic ramus insufficiency fracture in a patient with hyperparathyroidism.

Keywords

Insufficiency fracture, hyperparathyroidism

References

• Lourie H. Spontaneous osteoporotic fracture of the sacrum.An unrecognized syndrome of the elderly. JAMA 1982; 248:715-7.
• Lee YJ, Bong HJ, Kim JT, Chung DS. Sacral insuffi- ciency fracture, usually overlooked cause of lumbo- sacral pain. J Korean Neurosurg Soc 2008;44:166-9.
• Weber M, Hasler P, Gerber H. Insufficiency fractures of the sacrum. Twenty cases and review of the litera- ture. Spine (Phila Pa 1976) 1993;18:2507-12.
• Goergen TG, Resnick D, Riley RR. Post-traumatic abnormalities of the pubic bone simulating malig- nancy. Radiology 1978;126:85-7.
• Cooper KL, Beabout JW, Swee RG. Insufficiency fractures of the sacrum. Radiology 1985;156:15-20.
• Peh WC. Clinics in diagnostic imaging (60). Singa- pore Med J 2001; 42:183-6.
• Balaban B, Yaflar E, Tan AK, Kalyon TA. Sakral ye- tersizlik kırığı: Olgu sunumu ve literatür derlemesi. Romatizma 2005;20:33-37.
• Daffner RH, Pavlov H. Stress fractures: current con- cepts. AJR Am J Roentgenol 1992;159:245-52.
• Breuil V, Roux CH, Testa J, Albert C, Chassang M, Brocq O, et al. Outcome of osteoporotic pelvic frac- tures: an underestimated severity. Survey of 60 ca- ses. Joint Bone Spine2008;75:585-8
• White JH, Hague C, Nicolaou S, Gee R, Marchinkow LO, Munk PL. Imaging of sacral fractures. Clinical Radiology 2003;58:914-21.
• Soubrier M, Dubost J-J, Boisgard S, Sauverzie B, Gaillard P, Michel JL, et al. Insufficiency fracture. A survey of 60 case and review of the literature. Joint Bone Spine 2003;70:209-18.
• Albertsen AM, Egund N, Jurik AG, et al. Post- traumatic osteolysis of the pubic bone simulating malignancy. Acta Radiol 1994;35:40-4.
• Peh WCG, Khong PL, Yin Y, Ho WY, Evans NS, Gilula LA, et al. Imaging of pelvic insufficiency fractu- res. RadioGraphics 1996;16:335-48.
• Peh WCG, Evans NS. Tarlov cysts - another cause of sacral insufficiency fractures? Clin Radiol 1992; 46:329-30.
• Paker N, Tekdos. Sacral Insufficiency Fracture: Ca- se Report. Türk Fiz Tıp Rehab Derg 2006;52:129- 31.