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2020 Jun 14




Bilateral Simultaneous Proximal Tibial Insufficiency Fractures in a Patient Suffering From Psoriatic Arthritis.


Vlasis K, Angelis S, Apostolopoulos A, Filippou D, Papanikolaou A
Cureus. 2020 Jun 14; 12(6):e8616.
PMID: 32676251.


Bilateral synchronous proximal tibia insufficiency fractures are rarely reported. We present a case of simultaneous proximal tibia bilateral insufficiency fractures in a 51-year-old female patient with underlying psoriatic arthritis, who was on chronic steroid medication. She reported sudden onset of bilateral knee pain after intense workout one week ago. Initial clinical and X-ray evaluation did not reveal significant pathology. Four weeks later, due to persistent pain in the absence of significant radiographic findings during follow-up, the patient was referred for MRI, which revealed fractures of both proximal tibias. A "mixed" treatment protocol was applied. In particular, this protocol included combination of rest and intermittent removable knee ranger braces immobilization with weight-bearing when applied. The patient went on to make a full recovery. Chronic inflammatory disorders accompanied by suspicious clinical manifestations should be thoroughly inspected. Diagnostic and treatment protocols should be further discussed and implemented.