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Metastatic lung adenocarcinoma causes extensive destruction of the hip and pelvis.

BackgroundLung cancer is the most prevalent tumor and frequently present with distant metastases, with the bone being one of the most common affected sites. However, bone metastases leading to complete resorption of the hip joint and pelvis are extremely rare. This case aimed to report an extensive destruction of the hip and pelvis in metastatic lung adenocarcinoma, and conduct a literature review to explore the factors influencing the diagnosis and treatment decisions of bone metastasis.Case presentationA 56-year-old woman presented with progressive pain in her left hip joint and pelvis accom

Atypical Femoral Fracture in Patients With Metastatic Bone Tumors: An Analysis Based on the Japanese Adverse Drug Event Reaction Database (JADER).

Objective Denosumab (DEN)-related atypical femoral fracture (AFF) is a rare entity, and hence not feasible to examine with a single institution-based study. In light of this, we performed a retrospective analysis of the clinical characteristics of patients with metastatic bone tumors treated with DEN and developed AFF. Methods The Japanese Adverse Drug Event Report (JADER) database (2023.8 public version) from the second quarter of 2004 to the second quarter of 2023 was used to investigate the backgrounds of patients with metastatic bone tumors who developed AFF while receiving DEN. The time o

Hypophosphatemic Osteomalacia Induced by Low-Dose Adefovir-Related Fanconi Syndrome.

Adefovir dipivoxil (ADV), an antiviral agent for chronic hepatitis B virus infection, has been associated with nephrotoxicity, particularly Fanconi syndrome, even at low doses (10 mg/day). Fanconi syndrome is a generalized proximal tubular dysfunction leading to phosphate wasting and hypophosphatemic osteomalacia. Here, the author reports a case of a 58-year-old man with a 2-year history of bone pain involving the left foot, upper back, and left scapula, later extending to the right foot and chest wall, without antecedent trauma. Magnetic resonance imaging revealed insufficiency fractures in b

Correlation of the Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios with Postoperative Complications and Survival in Surgery for Bone Metastasis of the Appendicular Skeleton.

Objective To analyze, in cases of long-bone metastases, the incidence of postoperative complications and survival of up to 1 year, correlating them with the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Methods Review of 160 medical records of patients who underwent surgery for bone metastases in the appendicular skeleton. We determined epidemiological characteristics and NLR and PLR values, which were correlated with survival and complications. Results Women represented 64.5% of the sample, and 62.6% presented primary breast tumor. The proximal femur was the mos

Incidence of atypical femoral fractures in the treatment of bone metastasis: An alert report.

BackgroundAs the life expectancy of cancer-bearing patients has increased, more patients with bone metastasis are receiving long-term treatment with bone-modifying agents (BMAs; e.g., zoledronate and denosumab), which are a risk factor for developing atypical femoral fracture (AFF). In this study, we surveyed the risk of iatrogenic AFF using a clinical database on treatment of bone metastasis in the past 10 years.MethodsFrom April 2011 through October 2019, 721 patients with bone metastasis (436 men, 285 women; mean age, 65.7 ± 12.4 years) were registered under the bone metastasis consultation

Cementoplasty to cryoablation: review and current status.

Recent advances in percutaneous image-guided techniques have empowered interventional radiologists with diverse treatment options for the management of musculoskeletal lesions. Of note, there is growing utility for cementoplasty procedures, with indications ranging from stabilization of bone metastases to treatment of painful vertebral compression fractures. Likewise, cryoablation has emerged as a viable adjunct in the treatment of both primary and secondary bone and soft tissue neoplasms. These treatment options have been progressively incorporated into the multidisciplinary approach to holis

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… More recently, a systematic review compared the efficacy between cementoplasty alone versus cementoplasty augmented with fixation devices for impending pathologic proximal femoral fractures. …

Radial HR-pQCT and Finite Element Analysis in HPP Patients are Superior in Identifying Susceptibility to Fracture-Associated Skeletal Affections Compared to DXA and Laboratory Tests.

Hypophosphatasia (HPP) is an inborn disease that causes a rare form of osteomalacia, a mineralization disorder affecting mineralized tissues. Identification of patients at high risk for fractures or other skeletal manifestations (such as insufficiency fractures or excessive bone marrow edema) by bone densitometry and laboratory tests remains clinically challenging. Therefore, we examined two cohorts of patients with variants in the ALPL gene grouped by bone manifestations. These groups were compared by means of bone microarchitecture using high-resolution peripheral quantitative computed tomog

Osteoprotective Roles of Green Tea Catechins.

Osteoporosis is the second most common disease only secondary to cardiovascular disease, with the risk of fracture increasing with age. Osteoporosis is caused by an imbalance between osteoblastogenesis and osteoclastogenesis processes. Osteoclastogenesis may be enhanced, osteoblastogenesis may be reduced, or both may be evident. Inflammation and high reactive oxygen enhance osteoclastogenesis while reducing osteoblastogenesis by inducing osteoblast apoptosis and suppressing osteoblastic proliferation and differentiation. Catechins, the main polyphenols found in green tea with potent anti-oxida

Gaucher Disease in Bone: From Pathophysiology to Practice.

Gaucher disease (GD) is a rare, genetic lysosomal disorder leading to lipid accumulation and dysfunction in multiple organs. Involvement of the skeleton is one of the most prevalent aspects of GD and a major cause of pain, disability, and reduced quality of life. Uniform recommendations for contemporary evaluation and management are needed. To develop practical clinical recommendations, an international group of experienced physicians conducted a comprehensive review of 20 years' of the literature, defining terms according to pathophysiological understanding and pointing out best practice and

Multiple myeloma presenting with amyloid arthropathy as the first manifestation: Two case reports.

BACKGROUND: Multiple myeloma (MM) can be accompanied by amyloidosis, which occurs in a small number of patients and is characterized by deposition of light chains in the joints, leading to multiple myeloma-associated amyloid arthropathy (MAA). As a rare complication of MM, clinical manifestations of MAA are often similar to those of rheumatoid arthritis, and the two are easily confused. CASE SUMMARY: In recent years, our center treated two patients of MM with amyloid arthropathy as the first manifestation, both of whom presented with polyarthritis. After treatment for MM, both patients achiev

Comprehensive Study of the Risk Factors for Medication-Related Osteonecrosis of the Jaw Based on the Japanese Adverse Drug Event Report Database.

Medication-related osteonecrosis of the jaw (MRONJ) is associated with many drugs, including bisphosphonates (BPs). BPs are associated with atypical femoral fractures and osteonecrosis of the external auditory canal. Thus, many drugs are reported to cause adverse effects on bone. This study aimed to investigate the effects of drugs and patient backgrounds regarding osteonecrosis-related side effects, including MRONJ. This study used a large voluntary reporting database, namely, the Japanese Adverse Drug Event Report database. First, we searched for risk factors related to MRONJ using volcano p

Elective Surgical Care Pathways Are Associated With Lower Fracture Rates at Presentation and Contribute to Superior Clinical Outcomes in Metastatic Bone Disease.

BACKGROUND AND OBJECTIVES: Metastatic bone disease (MBD) often necessitates orthopaedic surgical intervention, which occurs through either emergent or elective care pathways. This study compared post-operative outcomes between patients undergoing elective versus emergent surgery for MBD involving the pelvis and appendicular skeleton. METHODS: We performed a retrospective, multicenter, propensity-matched cohort study of patients who underwent surgery for MBD. Emergent surgery was defined as an unplanned admission followed by unscheduled surgery, while elective surgery referred to cases with an

Low BMI, blood calcium and vitamin D, kyphosis time, and outdoor activity time are independent risk factors for osteoporosis in postmenopausal women.

AIM: To explore the risk factors of osteoporosis in postmenopausal women in China. METHOD: This study collected all patient data from January 2014 to December 2015. Basic information and questionnaires were collected from 524 postmenopausal women in Sanya and Hainan Province. The questionnaire was administered to the enrolled participants by endocrinologists. Biochemical parameters were measured using fasting blood samples, and bone density was measured by dual energy X-ray absorptiometry at the department of radiology of Hainan hospital, PLA General Hospital. Participants with an R-value of

Paraparesis and Disseminated Osteolytic Lesions Revealing Cholangiocarcinoma: A Case Report.

Bone metastases in cholangiocarcinoma are uncommon. We report the case of a patient with disseminated osteolytic lesions who was admitted to the Neurology Department for progressive paraparesis. On the computed tomography examination, specific features for cholangiocarcinoma were described, confirmed later by the histopathological aspect of the bone lesions.

Detection of avascular necrosis on routine diffusion-weighted whole body MRI in patients with multiple myeloma.

OBJECTIVE: Current therapies for multiple myeloma, which include corticosteroids, increase risk of avascular necrosis. The aim of this study was to assess incidental detection of femoral head avascular necrosis on routine whole body MRI including diffusion weighted MRI. METHODS: All whole body MRI studies, performed on patients with known multiple myeloma between 1 January 2010 to 1 May 2017 were assessed for features of avascular necrosis. RESULTS: 650 whole body MR scans were analysed. 15 patients (6.6%) had typical MR features of avascular necrosis: 2/15 (13.3%) had femoral head collapse,

Denosumab versus zoledronic acid for primary osteoporosis: a 36-month retrospective cohort study on bone mineral density changes.

OBJECTIVE: To explore and compare the clinical efficacy and safety of denosumab versus zoledronic acid for the treatment of primary osteoporosis. METHODS: This retrospective cohort study included 413 primary osteoporosis patients (denosumab, n = 198; zoledronic acid, n = 215). All received daily calcium (600 mg) and vitamin D (400 IU), representing the total combined daily intake from diet and supplements. The denosumab group received subcutaneous denosumab 60 mg every 6 months and the zoledronic acid group annual intravenous zoledronic acid 5 mg over 36 months. Outcomes assessed at baseline

Biologics for bone regeneration: advances in cell, protein, gene, and mRNA therapies.

Bone fractures represent a significant global healthcare burden. Although fractures typically heal on their own, some fail to regenerate properly, leading to nonunion, a condition that causes prolonged disability, morbidity, and mortality. The challenge of treating nonunion fractures is further complicated in patients with underlying bone disorders where systemic and local factors impair bone healing. Traditional treatment approaches, including autografts, allografts, xenografts, and synthetic biomaterials, face limitations such as donor site pain, immune rejection, and insufficient mechanical

Treatment Considerations for Severe Osteoporosis in Older Adults.

Osteoporosis, a chronic metabolic bone disease, increases the predisposition to fragility fractures and is associated with considerable morbidity, high health care cost as well as mortality. An elevation in the rate of incident fragility fractures will be observed proportional with the increase in the number of older people worldwide. Severe osteoporosis is currently defined as having a bone density determined by dual-energy X-ray absorptiometry that is more than 2.5 standard deviations (SD) below the young adult mean with one or more past fractures due to osteoporosis. Nutrition, physical act

Bone biology in the elderly: clinical importance for fracture treatment.

Age-related bone impairment often leads to fragility fractures in the elderly. Although excellent surgical care is widely provided, diagnosis and treatment of the underlying bone disorder are often not kept in mind. The interplay of the three major bone cells - osteoblasts, osteoclasts, and osteocytes - is normally well regulated via the secretion of messengers to control bone remodeling. Possible imbalances that might occur in the elderly are partly due to age, genetic risk factors, and adverse lifestyle factors but importantly also due to imbalances in calcium homeostasis (mostly due to vita

Orthopaedic Oncology in Contemporary Practice: A Comprehensive Review of Primary Bone Tumours, Metastatic Pathways, and Evolving Surgical Techniques.

Orthopaedic oncology encompasses the diagnosis and management of primary bone sarcomas and metastatic skeletal disease, requiring integration of oncologic principles with complex musculoskeletal reconstruction. Advances in molecular classification, cross-sectional imaging, systemic therapy, and surgical technology have substantially transformed contemporary clinical practice. This comprehensive review synthesises current evidence across epidemiology, tumour biology, diagnostic strategies, staging systems, multidisciplinary management, reconstructive techniques, complication profiles, and survi