scholarly journals A Turner Syndrome Case With Primary Amenorrhea Detected To Have Distal Radius Fracture And Severe Osteoporosis

2021 ◽  
Author(s):  
Nazlı Ölçilü ◽  
Figen Yılmaz ◽  
Jülide Öncü Alptekin ◽  
Banu Kıvran
Keyword(s):  
Bone Mineral Density ◽  
Distal Radius Fracture ◽  
Turner Syndrome ◽  
Distal Radius ◽  
Bone Mineral ◽  
Primary Amenorrhea ◽  
Mineral Density ◽  
Severe Osteoporosis ◽  
T Score ◽  
Replacement Treatment

Turner Syndrome (TS) is partial or total monosomy X with a prevalence of 2500/1 and characterized by premature ovarian failure, short stature, and multiple skeletal anomalies and is also called congenital ovarian dysplasia. Delayed puberty and estrogen deficiency are some of the determining factors for Osteoporosis formation in TS. Bone mineral density is among the best parameters to evaluate the bone mineral condition. Most female TS patients need estrogen replacement treatment to stimulate and continue feminization and to prevent osteoporosis. Forty-two years-old patient with TS was admitted to our clinic for rehabilitation following a right distal radius fracture occurring when she was trying to get up from the floor trying to get support from her right hand. The patient with primary amenorrhea wasn't admitted to the hospital before except her admittance for amenorrhea when she was 20 years old and was diagnosed with Turner syndrome. In her bone mineral density (DXA) measurement, L2-L4 vertebra BMD T-score was -4.0 (0.719 g/cm), Z score was -3.8, total femur T-score was 1.7 (0.788 g/cm) and femur neck T score was -1.7 (0.799). No pathological vertebral fractures were detected. The patient was given oral risedronate sodium 35 mg and calcium 1200 mg vitD 3 880 IU/day treatment for osteoporosis and followed-up. Our aim in this case presentation was to present the fact that severe osteoporosis and fracture may occur unless early hormone replacement treatment is started in a primary amenorrheic patient with Turner Syndrome.

scholarly journals Characterizing Bone Mineral Density Using Lumbar Spine Computed Tomography Attenuation in Patients With Distal Radius Fractures

2019 ◽  
Vol 10 ◽  
pp. 215145931984740 ◽  
Author(s):  
Christina M. Ward ◽  
Mark A. Arnold ◽  
Osa Emohare
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Bone Mineral ◽  
Radius Fracture ◽  
Mineral Density ◽  
Post Injury ◽  
Osteoporosis Screening ◽  
Ct Attenuation

Introduction: This study examines how many patients with distal radius fracture (DRF) eligible for bone health evaluation could potentially be screened using bone mineral density (BMD) estimation by L1 vertebra computed tomography (CT) attenuation obtained for other purposes. Materials and Methods: For all adult patients with DRF who presented over a 5-year period, we recorded the age, sex, dual-energy X-ray absorptiometry (DXA) results up to 3 years prior to injury or 1 year post-injury, and L1 CT attenuation on any CT including L1 that had been performed within 6 months of their fracture. 1 We compared the availability of L1 CT attenuation measurement to the rate of DXA scan use. We calculated the percentage of patients with osteoporosis and compared attenuation results to DXA results in those patients where both tests were available. Results: Of 1853 patients with DRF, an L1 CT had been obtained in 195 patients. Of the 685 patients who met criteria for osteoporosis screening, 253 (37%) patients had undergone only DXA screening, 68 (10%) patients had an L1 CT only, and 18 (2%) patients had both tests. Of the 86 patients who met criteria for osteoporosis screening and had an adequate CT, 67 (78%) demonstrated L1 attenuation <135 HU, and 79 (92%) had CT attenuation <160 HU. Discussion: Our study found that 10% of patients with a distal radius fracture who met the criteria for osteoporosis screening had a CT scan that could be used to estimate bone density and that the majority of those patients met criteria for osteoporosis based on CT attenuation. Conclusions: Utilization of opportunistic BMD screening with L1 CT attenuation offers the potential to increase osteoporosis screening from 40% to 50% of eligible patients and make the diagnosis of osteoporosis in an additional 8% of patients with DRF at no additional cost.

scholarly journals Patient-related outcome, fracture displacement and bone mineral density following distal radius fracture in young and older men

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Egund ◽  
Fiona E. McGuigan ◽  
Niels Egund ◽  
Jack Besjakov ◽  
Kristina E. Åkesson
Keyword(s):  
Bone Mineral Density ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Bone Mineral ◽  
Older Men ◽  
Initial Presentation ◽  
Radius Fracture ◽  
Mineral Density ◽  
Risk Of Fracture ◽  
Fracture Displacement

Abstract Background Distal radius fractures can adversely affect wrist function; for men with this fracture, the role played by fracture severity, age and osteoporosis on fracture outcome has not been sufficiently studied. Objective To describe patient-reported outcome and the association with bone integrity, fracture severity and future fracture risk among young and older men with distal radius fracture. Methods This prospective study includes 133 men with acute distal radius fracture, mean age 54 (range 21–88), who were followed for 12 months. They were categorized as younger (< 65) and older (65+). Main outcome was DASH (Disability of the Arm, Shoulder and Hand) at 12 months; DASH > 15 was defined as poor outcome. Fractures were classified and radiographic displacement identified at initial presentation and follow-up. BMD was measured and FRAX 10-year probability of fracture calculated. Results Disability was higher in older men (DASHmedian 10 vs 2; p = 0.002); a clinically meaningful difference (ΔDASH = 10, p = 0.017) remained after adjustment for displacement, fracture classification and treatment method. Almost 50% of older men vs 14% in younger had poor outcome, p < 0.001. Bone mineral density did not independently predict outcome. Older men with a displaced fracture at initial presentation had greater disability (DASHmedian, IQR 45, 14;73) and risk of fracture (FRAXmajor osteoporotic 14, 8;21). Conclusion Men over the age of 65 with a distal radius fracture are more likely to have post-fracture disability regardless of radiographic appearance. Fracture displacement, indicating impaired bone strength, is also more common and associated with an increased risk of fracture within 10-years. Secondary fracture prevention should therefore be considered in men presenting with distal radius fracture.

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