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OBJECTIVE To investigate the characteristics and regularity of denosumab-associated atypical fractures （AF）， so as to provide references for clinical rational use of drugs. METHODS The case reports of AF related to denosumab were retrieved from PubMed， Web of Science， CNKI， Wanfang data and VIP databases， and the reports were descriptively analyzed. RESULTS A total of 19 references were retrieved， including 20 patients. There were 3 males and 17 females， with an average age of （69.80± 15.39） years. Among 20 patients， primary diseases of 14 patients were osteoporosis， and 6 cases were malignant tumor bone metastasis and giant cell tumor of bone. The occurrence time of AF ranged from 3 to 132 months after the administration of denosumab， with an average of （42.14±29.49） months. Fourteen cases had prodromal symptoms before AF. There were 3 cases of ulna fractures， and the remaining 17 cases were femoral fractures. The vast majority of patients recovered well after discontinuing medication and undergoing surgical fixation， but some patients experienced delayed fracture healing. CONCLUSIONS Long-term use of denosumab should be vigilant against AF. When patients experience prodromal symptoms such as thigh， groin， hip joint and forearm pain， they should seek medical attention in a timely manner to ensure medication safety.
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Objective To analyze the clinical value of X ray examination, CT examination and MRI examination in the diagnosis of giant cell tumor of bone.Methods 50 patients with giant cell tumor of bone confirmed by postoperative pathology were selected.The patients' X ray, CT scan and MRI imaging examination data were retrospectively analyzed, and the imaging features of giant cell tumor of bone were discussed and summarized.Results The rate of CT examination and MRI examination in the diagnosis of bone destruction was higher than X ray examination, but the difference was not statistically significant (x2=4.181,P>0.05).CT examination and MRI examination in the soap bubble sign, bone crest, liquid plane and soft tissue mass in the diagnostic rate compared with X ray examination was significantly higher, the difference was statistically significant (x2=5.333,22.941,30.000,38.400,64.000,14.166,6.102,all P<0.05).Conclusion The diagnostic accuracy of CT and MRI in giant cell tumor of bone is higher than X ray, but the value of MRI examination in the diagnosis of edema near the tumor is better.