Identifying Incomplete Atypical Femoral Fractures With Single-Energy Absorptiometry: Declining Prevalence
| Autor: | Malachi J. McKenna, Kathleen Bennett, Paul Ward, Eric Heffernan, Carmel Silke, Fergus McKiernan, Susan van der Kamp, Conor Hurson, B McGowan |
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| Rok vydání: | 2016 |
| Předmět: |
Bone mineral
DXA Pediatrics medicine.medical_specialty Parathyroid Bone and Mineral Metabolism business.industry Endocrinology Diabetes and Metabolism medicine.medical_treatment Entire femur 030209 endocrinology & metabolism Bisphosphonate 03 medical and health sciences bisphosphonate therapy 0302 clinical medicine atypical femur fracture Medicine Femur 030212 general & internal medicine Bisphosphonate therapy business Prospective cohort study Clinical Research Articles |
| Zdroj: | Journal of the Endocrine Society |
| ISSN: | 2472-1972 |
| Popis: | Background: Atypical femur fractures (AFFs) are associated with long-term bisphosphonate (BP) therapy. Early identification of AFF prior to their completion provides an opportunity to intervene, potentially reducing morbidity associated with these fractures. Single-energy X-ray absorptiometry (SE) is an imaging method recently shown to detect incomplete AFF (iAFF) prior to fracture completion. Methods: Between May 2013 and September 2014, we assessed 173 patients who had been prescribed BP therapy for >5 years for iAFF using SE at their presentation for routine bone mineral density testing. We compared these findings with those of our previously published prospective study (n = 257) in which the femur was imaged for iAFF using dual-energy X-ray absorptiometry. In addition, we estimated the yearly prevalence of complete AFF among patients with subtrochanteric fracture at our institution from 2006 to 2014, and we evaluated prescribing trends for BP in Ireland from 2009 to 2014. Results: No patients had iAFF using SE femur compared with a prevalence of 2.7% in the earlier study. Between 2006 and 2014, we observed a rise and decline in AFFs at our hospital and a similar national trend in BP prescribing. Conclusions: AFFs appear to be decreasing. New customized scan modes of dual-energy X-ray absorptiometry systems, which visualize the entire femur at high image quality and take measurements, have the potential to identify iAFF prior to fracture completion and to ascertain those at highest risk of AFF. Atypical femur fractures (AFFs) are rare events that are associated with long-term bisphosphonate therapy. Using high-definition imaging with dual-energy X-ray absorptiometry machines, AFFs may be identified in the incomplete form. |
| Databáze: | OpenAIRE |
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