A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal Tibia
A 52-year-old woman presented herself with pain on the medial sides of the proximal tibia after a minimal trauma. Conventional X-rays did not show any pathology. However, the MRI showed a bilateral fracture of the proximal tibia. Since the patient was treated with methotrexate due to rheumatoid arth...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2016/5094906 |
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| author | J. Th. (Arjan) Hooghof Joris J. Mellema Marcel D. Posthumus Jos J. A. M. van Raaij |
| author_facet | J. Th. (Arjan) Hooghof Joris J. Mellema Marcel D. Posthumus Jos J. A. M. van Raaij |
| author_sort | J. Th. (Arjan) Hooghof |
| collection | DOAJ |
| description | A 52-year-old woman presented herself with pain on the medial sides of the proximal tibia after a minimal trauma. Conventional X-rays did not show any pathology. However, the MRI showed a bilateral fracture of the proximal tibia. Since the patient was treated with methotrexate due to rheumatoid arthritis, methotrexate osteopathy was considered. Long term treatment with low doses of methotrexate proved to inhibit osteoblast proliferation and may eventually lead to decreased bone formation and osteopenia. On the other hand, immobilization, joint deformities, and steroid treatment are associated with rheumatoid arthritis and are also known risk factors for fractures. The clinical relevance of methotrexate osteopathy still has to be established. However, if a patient treated with methotrexate localizes pain in the tibia, methotrexate osteopathy should be considered. Withdrawal of the drug may improve symptoms. |
| format | Article |
| id | doaj-art-b9e205a321364daf9bb186f993636311 |
| institution | Kabale University |
| issn | 2090-6749 2090-6757 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Orthopedics |
| spelling | doaj-art-b9e205a321364daf9bb186f9936363112025-02-03T01:32:54ZengWileyCase Reports in Orthopedics2090-67492090-67572016-01-01201610.1155/2016/50949065094906A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal TibiaJ. Th. (Arjan) Hooghof0Joris J. Mellema1Marcel D. Posthumus2Jos J. A. M. van Raaij3Department of Orthopaedic Surgery, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, NetherlandsDepartment of Orthopaedic Surgery, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, NetherlandsDepartment of Orthopaedic Surgery, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, NetherlandsDepartment of Orthopaedic Surgery, Martini Hospital, Van Swietenplein 1, 9728 NT Groningen, NetherlandsA 52-year-old woman presented herself with pain on the medial sides of the proximal tibia after a minimal trauma. Conventional X-rays did not show any pathology. However, the MRI showed a bilateral fracture of the proximal tibia. Since the patient was treated with methotrexate due to rheumatoid arthritis, methotrexate osteopathy was considered. Long term treatment with low doses of methotrexate proved to inhibit osteoblast proliferation and may eventually lead to decreased bone formation and osteopenia. On the other hand, immobilization, joint deformities, and steroid treatment are associated with rheumatoid arthritis and are also known risk factors for fractures. The clinical relevance of methotrexate osteopathy still has to be established. However, if a patient treated with methotrexate localizes pain in the tibia, methotrexate osteopathy should be considered. Withdrawal of the drug may improve symptoms.http://dx.doi.org/10.1155/2016/5094906 |
| spellingShingle | J. Th. (Arjan) Hooghof Joris J. Mellema Marcel D. Posthumus Jos J. A. M. van Raaij A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal Tibia Case Reports in Orthopedics |
| title | A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal Tibia |
| title_full | A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal Tibia |
| title_fullStr | A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal Tibia |
| title_full_unstemmed | A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal Tibia |
| title_short | A Woman with Rheumatoid Arthritis and a Bilateral Fracture of the Proximal Tibia |
| title_sort | woman with rheumatoid arthritis and a bilateral fracture of the proximal tibia |
| url | http://dx.doi.org/10.1155/2016/5094906 |
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