caa a22 4500 605463409 CHVBK 20210128100253.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00774-014-0611-9 doi (NATIONALLICENCE)springer-10.1007/s00774-014-0611-9 Prodromal Symptoms in Patients with Bisphosphonate-Associated Atypical Fractures of the Femur [Elektronische Daten] [Mohammad Kharazmi, Karl Michaëlsson, Pär Hallberg] Symptoms have been reported to precede bisphosphonate-associated atypical fractures (AFs) of the femoral shaft. We aimed to determine the frequency and clinical characteristics of such prodromal symptoms. We searched the Swedish national database of spontaneously reported adverse drug reactions for all cases of AF associated with bisphosphonates from January 2006 to March 2013. To confirm diagnostic accuracy and to characterize and determine the frequency of any prodromal symptoms we retrieved copies of medical journals and radiographs for patients who consented to participate in the study. The frequency of prodromal symptoms was compared with that of patients where information was based only on narratives from the adverse drug reaction case reports. A total of 45 reports of AF were identified. We were able to obtain medical records and x-rays for 21 cases and diagnostic accuracy was confirmed for all. Medical records revealed prodromal symptoms in 86 % (n=18), most commonly pain in the ipsilateral thigh (14 out of 18 patients) preceding the fracture for weeks or longer. Awareness of such symptoms may facilitate early diagnosis and possible prevention of the AF. The Japanese Society for Bone and Mineral Research and Springer Japan, 2014 Atypical fracture nationallicence Bisphosphonate nationallicence Prodromal symptom nationallicence Adverse drug reaction nationallicence Osteoporosis nationallicence Kharazmi Mohammad Department of Oral and Maxillofacial Surgery, Central Hospital, Västerås, 721 89, Västerås, Sweden aut Michaëlsson Karl Section of Orthopaedics, Department of Surgical Sciences, Uppsala University, 751 85, Uppsala, Sweden aut Hallberg Pär Department of Medical Sciences, Uppsala University, 751 85, Uppsala, Sweden aut Journal of Bone and Mineral Metabolism Springer Japan 33/5(2015-09-01), 516-522 0914-8779 33:5<516 2015 33 774 https://doi.org/10.1007/s00774-014-0611-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00774-014-0611-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kharazmi Mohammad Department of Oral and Maxillofacial Surgery, Central Hospital, Västerås, 721 89, Västerås, Sweden aut NATIONALLICENCE 700 1- Michaëlsson Karl Section of Orthopaedics, Department of Surgical Sciences, Uppsala University, 751 85, Uppsala, Sweden aut NATIONALLICENCE 700 1- Hallberg Pär Department of Medical Sciences, Uppsala University, 751 85, Uppsala, Sweden aut NATIONALLICENCE 773 0- Journal of Bone and Mineral Metabolism Springer Japan 33/5(2015-09-01), 516-522 0914-8779 33:5<516 2015 33 774