ABSTRACT

Pubic ramus insufficiency fractures, which are often overlooked and difficult to diagnose, are usually seen in postmenopausal elderly women. While treatment with conservative methods is possible, delays in diagnosis for patients with waist, hip and groin pain complaints may result in unnecessary invasive procedures. Bone scintigraphy and computer tomography are very sensitive diagnostic tools that can be used for this purpose. Elderly patients with osteoporosis and who use corticosteroids have higher risk factors for the occurence of such fractures. Therefore, in these patients, clinical suspicion is important for accurate diagnosis and treatment of pubic ramus insufficiency fractures. Consequently, along with the literature, we present a case of diagnosis and treatment of pubic ramus insufficiency fractures development in an elderly woman with osteoporosis who uses corticosteroids due to polymyalgia rheumatica. (Turkish Journal of Osteoporosis 2012;18:24-6)

Giris

Stres kiriklari siklikla yasli postmenopozal kadinlarda, elastik direnci azalmis anormal kemige normal veya düsük enerjili fizyolojik bir stres uygulandiginda olusur. Pelvik yetersizlik kiriklari en sik pubik ramusta ardindan sakrumda ve daha az siklikta asetabulumda görülür. (1) Tani konulmasi zor olan, siklikla gözden kaçabilen, özellikle bel, kalça ve kasik agrisiyla basvuran yasli kadin hastalarda, pubik yetersizlik kiriklarinin dogru tani ve tedavisi için klinik süphe önem tasimaktadir. Biz de bu düsünceyle polimiyalji romatika (PMR) tanisiyla kortikosteroid kullanan ve osteoporozu olan pubik ramus yetersizlik kirigi tanisi koydugumuz yasli postmenopozal kadin hastamizin klinik ve radyolojik bulgularini, tani ve tedavi yöntemlerini sunmayi amaçladik.