Hyperparathyroidism-induced secondary osteoporosis leading to recurrent non-traumatic vertebral compression fractures: A comprehensive case report

TL;DR

A 79-year-old woman with hyperparathyroidism experienced multiple non-traumatic vertebral fractures, highlighting the need to consider secondary osteoporosis in similar cases.

Contribution

This case report highlights the rare occurrence of multiple non-traumatic vertebral fractures caused by hyperparathyroidism.

Findings

The patient had multiple acute non-traumatic vertebral compression fractures.

Hyperparathyroidism was identified as the underlying cause of secondary osteoporosis.

The case underscores the importance of investigating secondary causes in patients with multiple vertebral fractures.

Abstract

Primary hyperparathyroidism, while increasing the susceptibility to osteoporosis, also amplifies the potential for fractures in vulnerable areas such as the femoral neck. It can also serve as an infrequent etiological factor behind vertebral compression fractures.

This report discusses a case of multiple acute non-traumatic vertebral compression fractures in a patient diagnosed with primary hyperparathyroidism. The patient, a 79-year-old female with osteopenia (T Score −2.0, medically treated), had a history of left breast cancer treated with a partial mastectomy and radiation therapy. She presented with midline back pain resulting from T12 and L2 compression fractures and underwent balloon kyphoplasty. A week later, she reported severe low back pain, despite the absence of any new traumatic event. Repeat imaging showed multiple new, acute compression fractures at T10, T11, L1, and L3. Further workup revealed elevated parathyroid hormone levels and hypercalcemia, leading to a diagnosis of hyperparathyroidism.

Multiple acute non-traumatic vertebral body compression fractures due to hyperparathyroidism is an uncommon clinical manifestation. This case emphasizes the need for an extended work-up of secondary osteoporosis in patients who experience multiple vertebral compression fractures.

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