Muneio Eric Paul, Chhatre Akhil, Gopal Nikhil, Yuh Clara, Hira Kashif, Suri Pranamya
Department of Physical Medicine & Rehabilitation, Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD, 21287, USA.
Department of Transitional Medicine, Detroit Medical Center Sinai-Grace Hospital, 6071 Outer Dr W, Detroit, MI, 48235, USA.
Interv Pain Med. 2023 Nov 10;2(4):100291. doi: 10.1016/j.inpm.2023.100291. eCollection 2023 Dec.
Primary hyperparathyroidism, while increasing the susceptibility to osteoporosis, also amplifies the potential for fractures in vulnerable areas such as the femoral neck. It can also serve as an infrequent etiological factor behind vertebral compression fractures.
This report discusses a case of multiple acute non-traumatic vertebral compression fractures in a patient diagnosed with primary hyperparathyroidism. The patient, a 79-year-old female with osteopenia (T Score -2.0, medically treated), had a history of left breast cancer treated with a partial mastectomy and radiation therapy. She presented with midline back pain resulting from T12 and L2 compression fractures and underwent balloon kyphoplasty. A week later, she reported severe low back pain, despite the absence of any new traumatic event. Repeat imaging showed multiple new, acute compression fractures at T10, T11, L1, and L3. Further workup revealed elevated parathyroid hormone levels and hypercalcemia, leading to a diagnosis of hyperparathyroidism.
Multiple acute non-traumatic vertebral body compression fractures due to hyperparathyroidism is an uncommon clinical manifestation. This case emphasizes the need for an extended work-up of secondary osteoporosis in patients who experience multiple vertebral compression fractures.
原发性甲状旁腺功能亢进症在增加骨质疏松易感性的同时,也会加大股骨颈等脆弱部位骨折的可能性。它还可能是椎体压缩性骨折罕见的病因。
本报告讨论了一例被诊断为原发性甲状旁腺功能亢进症的患者发生多发性急性非创伤性椎体压缩性骨折的病例。该患者为一名79岁女性,患有骨质减少症(T值为-2.0,接受药物治疗),有左侧乳腺癌病史,曾接受保乳手术和放射治疗。她因T12和L2椎体压缩性骨折出现中线背痛,并接受了球囊后凸成形术。一周后,尽管没有发生任何新的创伤事件,她仍报告严重的下背痛。重复影像学检查显示T10、T11、L1和L3出现多个新的急性压缩性骨折。进一步检查发现甲状旁腺激素水平升高和高钙血症,从而诊断为甲状旁腺功能亢进症。
甲状旁腺功能亢进导致的多发性急性非创伤性椎体压缩性骨折是一种罕见的临床表现。该病例强调了对发生多发性椎体压缩性骨折的患者进行继发性骨质疏松症全面检查的必要性。