Abstract
Bisphosphonates (BP) are a commonly prescribed class of drugs for the prevention of
osteoporosis-related fractures. Paradoxically, however, they have recently been linked
to atypical fractures in the shaft of the femur. Since many physicians including radiologists,
are not aware of this entity, the incidence is likely underreported. These fractures
usually occur in the sub-trochanteric region of the femur in the setting of low-energy
trauma. It starts as a fracture line involving the lateral cortex and then progresses
medially to give rise to a complete fracture. The fracture line is usually transverse,
and there is a medial spike associated with a complete fracture. These fractures can
be bilateral. Awareness of these atypical fractures and their radiological appearance
should enable their early and accurate detection and thus lead to specific treatment.
Keywords
Bisphosphonates - femoral fractures - hip fractures
