Detection and management of atypical femur fractures.

Abstract

PURPOSE OF REVIEW:

This article summarizes the risk factors for atypical femur fractures (AFF), discusses current and emerging imaging modalities for early identification of AFF, and offers recommendations for prevention and management of AFFs based on the current concepts.

RECENT FINDINGS:

Antiresorptive therapies are widely recommended for prevention and treatment of osteoporosis. Despite their well established effectiveness to reduce fracture risk, emerging concerns related to potential adverse effects have led to a substantial decline in the use of bisphosphonates. Although, the pathogenesis of AFF has not yet been elucidated, the bulk of evidence supports that the well known therapeutic benefits of bisphosphonate far outweigh the relatively low risk of AFFs. Recommendations for early identification of patients at risk for AFF using radiographic imaging have been established. Consensus on the management of AFF and osteoporosis in patients with AFF needs to be formulated.

SUMMARY:

AFF is a rare event associated with long-term bisphosphonate therapy, which represents an apparent paradox in the management of osteoporosis. Improved understanding of pathogenetic mechanisms will be helpful in further refining of screening guidelines and standardization of management and treatment strategies.

• Authors: Vidita Divan, Sudhaker D Rao, Ruban Dhaliwal
• Journal: Current opinion in endocrinology, diabetes, and obesity (Curr Opin Endocrinol Diabetes Obes) Vol. 26 Issue 6 Pg. 283-290 (12 2019) ISSN: 1752-2978 [Electronic] England
• PMID: 31592780 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)

Chemical References

• Bone Density Conservation Agents
• Diphosphonates

Topics

• Bone Density Conservation Agents (adverse effects, therapeutic use)
• Diagnostic Imaging (methods, trends)
• Diphosphonates (adverse effects, therapeutic use)
• Femoral Fractures (diagnosis, etiology, prevention & control, therapy)
• Humans
• Osteoporosis (drug therapy)
• Osteoporotic Fractures (diagnosis, therapy)
• Practice Guidelines as Topic
• Preventive Medicine (methods, standards)
• Risk Assessment
• Risk Factors