During the past year the authors have observed four male patients with rheumatoid arthritis in whom severe compression fractures of the vertebrae have developed during the administration of cortisone or corticotropin or both. Although demineralization of the skeleton is a recognized complication of cortisone therapy, these cases have prompted the authors to emphasize the importance of possible pathological fractures when prolonged treatment of this nature is used.
Demartini, Grokoest, and Ragan,1 in 1952, reported pathological fractures in five patients who had received intensive cortisone therapy. As these authors pointed out, however, other factors predisposing to osteoporosis were present in that all five patients were women (four had passed the menopause) and three had severe rheumatoid arthritis. In the same year Teicher and Nelson2 reported the case of a young woman with pemphigus vulgaris who was treated for three years with cortisone, during which time pathological compression fractures from
Curtiss PH, Clark WS, Herndon CH. VERTEBRAL FRACTURES RESULTING FROM PROLONGED CORTISONE AND CORTICOTROPIN THERAPY. JAMA. 1954;156(5):467–469. doi:10.1001/jama.1954.02950050007002
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