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Case Reports in Orthopedics
Volume 2013 (2013), Article ID 350236, 3 pages
http://dx.doi.org/10.1155/2013/350236
Case Report

An Unusual Stress Fracture in an Archer with Hypophosphatasia

MS Baltalimani Bone Diseases Training and Research Hospital, Orthopaedics and Traumatology Department, 34470 Istanbul, Turkey

Received 5 September 2013; Accepted 12 November 2013

Academic Editors: P. Carpintero, V. Chouhan, and V. Subbiah

Copyright © 2013 Umut Yavuz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report a 45-year-old male archer with stress fracture in his left ulna on the background of adult type of hypophosphatasia. The patient presented to several medical centers for pain around the left elbow and received medical treatment upon diagnosis of tenosynovitis. History of the patient revealed that he had had diagnosis of hypophosphatasia ten years ago and underwent percutaneous screwing for stress fracture on both of his femoral necks. Upon finding nondisplaced stress fracture on proximal metaphysis of the ulna on X-ray, the patient underwent magnetic resonance imaging (MRI) in order to exclude pathological causes. No additional pathology was observed in MRI scanning. The patient’s sportive activities were restricted for 6 weeks and he received conservative management with arm slings. Adult type of hypophosphatasia is a disease manifesting with widespread osteoporosis and presenting with low serum level of alkali phosphatase (ALP). Stress fracture should definitely be considered in the patients with history of hypophosphatasia and refractory extremity pain.