Insufficiency-type stress fractures in rheumatoid arthritis: report of an interesting case and review of the literature.

A case of multiple insufficiency-type stress fractures (32 fractures), in the absence of any trauma, in a 51-year-old white woman with rheumatoid arthritis is described. The fractures healed satisfactorily with rest, treatment of osteoporosis, and discontinuation of her steroid therapy, following which a proximal humeral and total knee arthroplasties were successfully performed. The factors contributory to the development of stress fractures in rheumatoid arthritis are discussed, the literature is reviewed, and the salient features of our case are highlighted.