Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
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Review Case Reports
Osteopenia, bone fragility and reflex sympathetic dystrophy syndrome in a man with ureterosigmoidostomy.
A 68-year-old man is presented with a reflex sympathetic dystrophy syndrome (RSDS) of the right ankle diagnosed by radiography, magnetic resonance imaging and bone scintiscan. Investigations, including blood tests and bone biopsy, revealed a diagnosis of metabolic acidosis and osteomalacia. ⋯ Correction of the metabolic acidosis coincided with improvement in ankle pain. RSDS may be the initial presentation of osteomalacia, which in turn may be caused by the metabolic acidosis resulting from a ureterosigmoidostomy.
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To improve knowledge of the current trends in the number and incidence of age-related minor trauma knee fractures, we selected from the National Hospital Discharge Register all patients 60 years old or older who were admitted to Finnish hospitals in 1970-1972, 1974-1975, 1978-1980, 1983-1985, 1988-1989 and 1991-1994 for primary treatment of first knee fracture. The knee fracture was defined to be a "minor trauma" fracture if it had occurred as a result of a fall from standing height or less. We also predicted fracture development until the year 2020 by a regression model, which took into account the predicted changes in fracture incidences and population at risk. ⋯ If this trend continues, there will be about 2 times more minor trauma knee fractures in Finnish women in the year 2020 than there were in 1994. In Finnish men aged 60 years or more the absolute numbers and incidences of these fractures did not show consistent trend changes over time. We conclude that the number of minor trauma knee fractures in elderly Finnish women in increasing more rapidly than can be accounted for by the demographic changes alone and therefore effective preventive measures should urgently be adopted to control the increasing burden of these age-related fractures.
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The relative importance of vitamin D deficiency, secondary hyperparathyroidism, nutritional deficiency and low bone mineral density (BMD) as risk factors for hip fracture is not definitely established. In the framework of a case-control study of risk factors for hip fractures, biochemical markers of bone metabolism and nutrition and femoral BMD data were compared in 136 female and 43 male hip fracture patients, 136 female and 44 male age-matched hospitalized controls, and 47 healthy elderly women (8 men). Patients with hip fracture had lower albumin (-10%) and 25(OH)-vitamin D (25(OH)D; -19%) compared with hospitalized controls, and lower albumin (-28%) and 25(OH)D levels (-52%) compared with the elderly controls. ⋯ In men. IGFBP-3 was correlated with BMD. The femoral BMD depended only weakly on PTH and 25(OH)D, but was correlated at all sites with albumin, a non-specific parameter of nutrition and general health.