Stress fracture of the inferior and superior pubic ramus in a man with anorexia nervosa and hypogonadism.

The authors present the case of a 23-year-old athlete with a bifocal stress fracture of the pubis. Bifocal cases are rather rare, therefore an insufficiency fracture was suspected. Further investigation showed osteopenia due to secondary hypogonadotropic hypogonadism caused by anorexia nervosa. This case illustrates the need for awareness of underlying metabolic disorders in very rare cases of stress fractures in athletes.