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Stress fractures of the lower limb in patients with rheumatoid arthritis.

Authors
  • Young, A
  • Kinsella, P
  • Boland, P
Type
Published Article
Journal
The Journal of bone and joint surgery. British volume
Publication Date
Aug 01, 1981
Volume
63-B
Issue
2
Pages
239–243
Identifiers
PMID: 7217149
Source
Medline
License
Unknown

Abstract

Thirteen patients suffering from rheumatoid arthritis had 19 stress fractures of the tibia or fibula. These patients characteristically presented with sudden, severe, unexplained pain with localised tenderness just below the knee or above the ankle. In seven patients examination of the adjacent joint indicated a flare-up of disease activity or a pyogenic arthritis. In six patients the diagnosis was delayed by the late appearance of callus in minute fractures. All patients had rheumatoid deformities of the ipsilateral lower limb: valgus deformities of the knee and subtalar joints occurred most frequently. All patients had osteoporosis; all except two had received steroid treatment and five had abnormalities of calcium metabolism. We suggest that deformities of the knee and ankle predispose patients with rheumatoid arthritis and osteoporosis to stress fractures of the tibia and fibula.

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