Alendronic acid

A 64-year-old woman with postmenopausal osteoporosis developed bilateral femoral shaft stress injuries and incomplete atypical femoral fractures during prolonged treatment with alendronate. The woman had received alendronate for 4 years when she began experiencing prodromal thigh pain. Magnetic resonance imaging revealed Grade 3 stress injuries in both femoral shafts, characterised by lateral cortical involvement and surrounding marrow oedema, consistent with early incomplete atypical femoral fractures. Subsequent radiographs confirmed atypical transverse fracture patterns with lateral cortical beaking and minimal comminution. The woman’s antiresorptive therapy was modified and she underwent timely surgical intervention. …