Insufficiency fracture of the sternum

Case contributed by Dr Chris O'Donnell

Presentation

PH of carcinoma of the breast. Routine follow-up includes abnormal bone scan. Taking risedronate for osteoporosis (DEXA T score -2.6 left neck of femur).

Patient Data

Age: 75
Gender: Female
Nuclear medicine

Focal, isolated, intense, hot spot in the mid sternal body of this whole body bone scan without any other abnormal isotope accumulation in bone apart from the acromio-clavicular joints.

Sclerotic lesion in the mid sternum with a central linear defect indicative of a healing fracture. Biopsy showed mature trabecular bone with fibrosis and haemosiderin, osteoid, chondral elements and immature bone. No occult malignant cells on immunoperoxide staining.

Case Discussion

Insufficiency fractures of the sternum are rare in osteoporosis and were said to result from excessive forces on the sternum in elderly patients with kyphosis although this has been refuted 1.  CT findings are typical of any fracture with a linear defect (with or without buckling of the cortex) and surrounding sclerosis (healing).

PlayAdd to Share

Case information

rID: 37580
Case created: 14th Jun 2015
Last edited: 21st Nov 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.