Chang-Hee Lee1,2, Seung Hyun Son1, Chae Moon Hong1,2, Ju Hye Jeong1,2, Shin Young Jeong1,2, Sang-Woo Lee1,2, Jaetae Lee1,2, Tae-Geon Kwon3, Byeong-Cheol Ahn1,2. 1. 1Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. 2. 2Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea. 3. 3Department of Oral & Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, South Korea.
Abstract
PURPOSE: Bisphosphonate (BP) is the first-line therapy for the management of osteoporosis. BP-related osteonecrosis of the jaw (BRONJ) and atypical femoral fracture (AFF) are increasingly common comorbidities in patients with osteoporosis under long-term BP treatment. The aim of this study was to evaluate the incidence and risk factors for AFF features on bone scintigraphy in patients with BRONJ. METHODS: Among total of 373 BRONJ patients treated between September 2005 and July 2014, 237 (220 women, 17 men; median age 73 years) who underwent three-phase bone scintigraphy were enrolled for this retrospective study. AFF features on bone scintigraphy and the related clinical factors were assessed. RESULTS: Among 237 patients with BRONJ, 11 (4.6%) showed AFF features on bone scintigraphy. BP medication duration (p = 0.049) correlated significantly with AFF features on bone scintigraphy in patients with BRONJ. BP intake duration of 34 months was the cutoff value for predicting the presence of AFF features on bone scintigraphy. Among the patients with BRONJ, all those with AFF features on bone scintigraphy were female patients with osteoporosis who were on oral BP medication; however, these factors were not significantly different along with AFF features on bone scintigraphy. CONCLUSION: The incidence of AFF features on bone scintigraphy was relatively high in patients with BRONJ. A careful observation of patients presenting with the AFF features on bone scintigraphy may be needed, particularly for female BRONJ patients with osteoporosis who have been on BP medication for over 34 months.
PURPOSE: Bisphosphonate (BP) is the first-line therapy for the management of osteoporosis. BP-related osteonecrosis of the jaw (BRONJ) and atypical femoral fracture (AFF) are increasingly common comorbidities in patients with osteoporosis under long-term BP treatment. The aim of this study was to evaluate the incidence and risk factors for AFF features on bone scintigraphy in patients with BRONJ. METHODS: Among total of 373 BRONJ patients treated between September 2005 and July 2014, 237 (220 women, 17 men; median age 73 years) who underwent three-phase bone scintigraphy were enrolled for this retrospective study. AFF features on bone scintigraphy and the related clinical factors were assessed. RESULTS: Among 237 patients with BRONJ, 11 (4.6%) showed AFF features on bone scintigraphy. BP medication duration (p = 0.049) correlated significantly with AFF features on bone scintigraphy in patients with BRONJ. BP intake duration of 34 months was the cutoff value for predicting the presence of AFF features on bone scintigraphy. Among the patients with BRONJ, all those with AFF features on bone scintigraphy were female patients with osteoporosis who were on oral BP medication; however, these factors were not significantly different along with AFF features on bone scintigraphy. CONCLUSION: The incidence of AFF features on bone scintigraphy was relatively high in patients with BRONJ. A careful observation of patients presenting with the AFF features on bone scintigraphy may be needed, particularly for female BRONJ patients with osteoporosis who have been on BP medication for over 34 months.
Entities:
Keywords:
Atypical femoral fracture; Bisphosphonate-related osteonecrosis of the jaw; Bone scintigraphy; Prevalence
Authors: Salvatore L Ruggiero; Thomas B Dodson; Leon A Assael; Regina Landesberg; Robert E Marx; Bhoomi Mehrotra Journal: J Oral Maxillofac Surg Date: 2009-05 Impact factor: 1.895
Authors: Jörg Schilcher; Veronika Koeppen; Jonas Ranstam; Ralf Skripitz; Karl Michaëlsson; Per Aspenberg Journal: Bone Date: 2012-10-22 Impact factor: 4.398
Authors: Dennis M Black; Pierre D Delmas; Richard Eastell; Ian R Reid; Steven Boonen; Jane A Cauley; Felicia Cosman; Péter Lakatos; Ping Chung Leung; Zulema Man; Carlos Mautalen; Peter Mesenbrink; Huilin Hu; John Caminis; Karen Tong; Theresa Rosario-Jansen; Joel Krasnow; Trisha F Hue; Deborah Sellmeyer; Erik Fink Eriksen; Steven R Cummings Journal: N Engl J Med Date: 2007-05-03 Impact factor: 91.245
Authors: Elizabeth Shane; David Burr; Bo Abrahamsen; Robert A Adler; Thomas D Brown; Angela M Cheung; Felicia Cosman; Jeffrey R Curtis; Richard Dell; David W Dempster; Peter R Ebeling; Thomas A Einhorn; Harry K Genant; Piet Geusens; Klaus Klaushofer; Joseph M Lane; Fergus McKiernan; Ross McKinney; Alvin Ng; Jeri Nieves; Regis O'Keefe; Socrates Papapoulos; Tet Sen Howe; Marjolein C H van der Meulen; Robert S Weinstein; Michael P Whyte Journal: J Bone Miner Res Date: 2013-10-01 Impact factor: 6.741
Authors: Felice S O'Ryan; Sam Khoury; Wendy Liao; Myo M Han; Rita L Hui; David Baer; Daniel Martin; Donald Liberty; Joan C Lo Journal: J Oral Maxillofac Surg Date: 2009-07 Impact factor: 1.895
Authors: Charles H Chesnut; Arne Skag; Claus Christiansen; Robert Recker; Jacob A Stakkestad; Arne Hoiseth; Dieter Felsenberg; Hermann Huss; Jennifer Gilbride; Ralph C Schimmer; Pierre D Delmas Journal: J Bone Miner Res Date: 2004-03-29 Impact factor: 6.741
Authors: Sundeep Khosla; David Burr; Jane Cauley; David W Dempster; Peter R Ebeling; Dieter Felsenberg; Robert F Gagel; Vincente Gilsanz; Theresa Guise; Sreenivas Koka; Laurie K McCauley; Joan McGowan; Marc D McKee; Suresh Mohla; David G Pendrys; Lawrence G Raisz; Salvatore L Ruggiero; David M Shafer; Lillian Shum; Stuart L Silverman; Catherine H Van Poznak; Nelson Watts; Sook-Bin Woo; Elizabeth Shane Journal: J Bone Miner Res Date: 2007-10 Impact factor: 6.741