Page 20 - Delaware Medical Journal - November/December 2020
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Femoral Neck and Sacral Insufficiency Fractures Secondary to Celiac Disease- Induced Osteomalacia:
A Case Report
Thomas R. Merring, PA-C; James J. Rubano, MD, MBA
INTRODUCTION
Atraumatic fractures typically fall under either the insufficiency or stress type. Insufficiency fractures are the result of normal stresses on abnormal bone, while stress fractures are due
to abnormal stresses on normal bone. While stress fractures can be seen
in young, healthy patients involved
in repetitive, high-impact activities
— such as long distance runners or military trainees during “boot camp” — insufficiency fractures are not usually seen in this patient population. Therefore, when a young patient presents with a femoral neck or sacral fracture and no history of repetitive overuse or force, it is important to keep in mind some underlying disease process that may be contributing to
a decrease in bone strength. Celiac
disease is an autoimmune response
to the ingestion of gluten, with rare musculoskeletal manifestations. In
this report, we present a 40-year-old healthy female with no past medical problems who developed insufficiency fractures of the femoral neck and sacrum secondary to osteomalacia. The underlying cause of osteomalacia was severe vitamin D deficiency due to undiagnosed celiac disease.
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Del Med J | November/December 2020 | Vol. 92 | No. 6
