Revue du rhumatisme (English ed.)
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Although falls are a major factor in the occurrence of femoral neck fractures, their type and frequency have not been studied in detail. A few case-reports have demonstrated that bone insufficiency can lead to femoral neck fracture and that some falls occur as a result of acute pain preceding the fracture. Estimations of the proportion of femoral neck fractures due to bone insufficiency have ranged from 3% to 24%. ⋯ Features associated with spontaneous fracture were pain during the preceding weeks (7/8; p<0.01), gradually worsening pain (6/7; p<0.02), pain in the inguinal or crural area (6/7), and recent onset of pain (< 3 months) (5/7). We believe that the incidence of bond insufficiency as a cause of femoral neck fracture has been substantially underestimated as a result of diagnostic difficulties and of the usually moderate severity of prefracture pain. Improved knowledge of prefracture symptoms provided by a prospective study may allow appropriate treatment by elimination of weight-bearing, avoiding a substantial number of femoral neck fractures.
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Synthetic antimalarial agents can cause exacerbation of latent or patent psoriatic skin lesions. A case of psoriatic onychoperiostitis precipitated by hydroxychloroquine therapy is reported. The patient had primary Sjögren's syndrome, raising questions about the incidence and causation of the ungual abnormalities associated with this condition.