ArticleSkeletal radiology2015
Bilateral atypical femoral fractures: how much symmetry is there on imaging?
Article in Skeletal radiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Radiographic Evolution of Contralateral Asymptomatic Incomplete Atypical Femoral Fractures in Autoimmune Disease Patients.Diagnostics (Basel, Switzerland) · 2026Article
- Prevalence and risk factors for atypical femoral fracture among Lebanese patients with hip and shaft fractures.JBMR plus · 2024Article
- Factors Affecting the Second Complete Atypical Femoral Fracture after the First Atypical Fracture.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2024Article
- Surgical strategy of the treatment of atypical femoral fractures.World journal of orthopedics · 2023Review
- Bilateral Atypical Femoral Fractures after Bisphosphonate Treatment for Osteoporosis: A Literature Review.Journal of clinical medicine · 2023Review
- Fracture Risk Following an Atypical Femoral Fracture.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Article
- Bisphosphonate therapy associated with bilateral atypical femoral fracture and delayed union.Joint diseases and related surgery · 2022Article
- Clinical Features and Outcomes of Bilateral Atypical Femoral Fractures.Case reports in orthopedics · 2020Article
- Atypical femur fractures: a survey of current practices in orthopedic surgery.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2017Article
- Atypical femoral fracture.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Article
- Identifying Incomplete Atypical Femoral Fractures With Single-Energy Absorptiometry: Declining Prevalence.Journal of the Endocrine Society · 2017Article
- Antenatal corticosteroids.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Article
- Bilateral atypical femur fractures without bisphosphonate exposure.Skeletal radiology · 2017Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate bilateral atypical femoral fractures (AFFs) and to compare imaging features of paired fractures. MATERIALS AND
methodsBilateral femoral imaging studies of 124 patients on bisphosphonate therapy with at least one AFF were retrospectively reviewed. Time between AFF diagnoses was determined. The following imaging features were evaluated for each AFF: fracture location, femoral angle, length of cortical thickening, medial spike location, fracture orientation, and comminution. Associations between imaging findings on pairs of bilateral AFFs were assessed with Spearman's correlation (rs) and the Kappa statistic (κ).
resultsBilateral AFFs were present in 78/124 (62.9%) cases (3 men, 75 women; mean age 67.3 years). Average time between contralateral AFF diagnoses was 10.3 months. Contralateral AFFs were diagnosed within 12 months of the index fracture in 60/78 (76.9%) cases and within 3 years in 69/78 (88.5%) cases. There was a strong correlation between bilateral AFF locations (rs = 0.65), with 58/76 (76.3%) occurring within a distance of <5 cm and 41/76 (53.9%) within a distance of ≤2.5 cm. Bilateral AFF pairs had moderately correlated femoral angles (rs = 0.42), and weakly correlated lengths of cortical thickening (rs = 0.28). There was substantial agreement for medial spike location (κ = 0.68) and fracture orientation (κ = 0.64), and moderate agreement for lack of comminution (κ = 0.42). All findings were independent of time between AFF diagnoses.
conclusionsPatients with unilateral atypical femoral fractures are likely to be diagnosed with a contralateral AFF within the first year of presentation. Bilateral AFFs commonly have similar imaging features, including location along the femur.
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