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Park, Seo, Cho, and Kim: Long Term Use of Glucocorticoid Induced Osteoporotic Multiple Compression Fractures in Autoimmune Diseases
Original Article

J Korean Rheum Assoc 2009;16(3):228-231.

Published online: 20 September 2009

DOI: https://doi.org/10.4078/jkra.2009.16.3.228

Long Term Use of Glucocorticoid Induced Osteoporotic Multiple Compression Fractures in Autoimmune Diseases

Ye-Soo Park1, Wan-Sik Seo2, Jae-Lim Cho2, Tae-Hwan Kim3

1Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, Guri, Korea

2Department of Orthopaedic Surgery, Hanyang University College of Medicine, Seoul, Korea

3Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea

Received 14 May 2009       Revised 23 June 2009       Accepted 23 June 2009

Copyright © 2009 The Korean Rheumatism Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reduced bone mineral density precedes the development of vertebral fractures in patients under long term glucocorticoid therapy. Osteoporosis is a frequent complication in steroid-dependent patients, and the risk of developing vertebral fractures in these patients is much higher than involutional osteoporosis. We described a 54-year-old patient who presented with autoimmune hepatitis and had a 6-year history of steroid medication. The patient had multiple compression fractures (T10∼L5) without trauma, and was treated successfully with multi-level vertebroplasty and an intravenous injection of bisphosphonate without complications.

Keywords: Autoimmune disease, Steroid, Osteoporotic vertebral fracture

References

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Fig. 1.
Lumbar plain radiography (Pre-operative). Lumbar AP (A) and Lateral (B) x-ray shows multiple compression fractures (T12, L1, 2, 4, 5).
jkra-16-228f1.tif
Fig. 2.
Lumbar MRI. Gadolinium-enhanced sagittal image of the lumbar spine shows signal intensity (arrow) of the fractured vertebral segments (T12, L1, 2, 4, 5).
jkra-16-228f2.tif
Fig. 3.
Lumbar 3D-CT. One month after the MRI check up, the sagittal CT image shows the progression (arrow) of the fractured segments (T10, 11, 12, L1, 2, 3, 4, 5).
jkra-16-228f3.tif
Fig. 4.
Lumbar plain radiography (Post-operative). Lumbar AP (A) and Lateral (B) x-ray shows multiple vertebroplasty segments (T10∼L5).
jkra-16-228f4.tif
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