A rare side effect of methotrexate therapy: drug-induced osteopathy with multiple fractures of the lower limb.
RMD Open
; 9(1)2023 02.
Article
em En
| MEDLINE
| ID: mdl-36810186
ABSTRACT
Methotrexate is associated with bone lesions that are rare and, although presenting with a typical localisation to the lower extremities and appearing with a characteristic radiologic morphology, largely unknown and often misdiagnosed as osteoporotic insufficiency fractures. The correct and early diagnosis, however, is key for treatment and prevention of further osteopathology. Here, we present a patient with rheumatoid arthritis who developed multiple painful insufficiency fractures in the left foot (processus anterior calcanei, tuber calcanei) and in the right lower leg and foot (anterior and dorsal calcaneus and at the cuboid and distal tibia) during therapy with methotrexate, which were all misdiagnosed as osteoporotic. The fractures occurred between 8 months and 35 months after starting methotrexate. Discontinuation of methotrexate resulted in rapid pain relief and no further fractures have occurred. This case powerfully demonstrates the importance of raising awareness of methotrexate osteopathy in order to take appropriate therapeutic measures, including and perniciously discontinuing methotrexate.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Fraturas de Estresse
/
Fraturas por Osteoporose
/
Fraturas Múltiplas
Tipo de estudo:
Screening_studies
Limite:
Humans
Idioma:
En
Revista:
RMD Open
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Alemanha