RESUMO
Denosumab is a commonly used antiresorptive treatment in patients with osteoporosis or solid tumours with bone metastases. Upon denosumab discontinuation, a rebound phenomenon can occur that results in an increased (vertebral) fracture risk. This phenomenon is well-known in the setting of osteoporosis but rarely reported in cancer patients with bone metastases discontinuing denosumab. We present the case of a 43-year old women with lung cancer and bone metastases who suffered multiple vertebral fractures after discontinuation of denosumab.
RESUMO
UNLABELLED: It has been demonstrated that the use of echography during intra-articular shoulder infiltrations provides superior results. The correct infiltration technique and the related (contra-) indications are still under discussion. The authors' objective was to ascertain how intra-articular shoulder infiltrations are done in Holland and Flanders. An electronic questionnaire was answered by 35 members of the FLESSS (Flanders) and 30 members of the WSE (Netherlands) and was then processed statistically. RESULTS: 21.54% of those questioned think they have sufficient experience with the use of echography during intra-articular infiltrations. 87.7% of the orthopaedists give a normal dose of corticoids to diabetes patients and more than 71% infiltrate when anticoagulants are used. Whereas 68.57% of the Flemish use posterior infiltration, 76.67% of the Dutch give an anterior injection. CONCLUSIONS: Echography is not used enough as an aid for intra-articular shoulder infiltrations. Neither diabetes mellitus nor anticoagulants are considered to be contra-indications. The Flemish shoulder specialists mainly administer posterior infiltration with methylprednisolone. The Dutch orthopaedists mainly administer anterior infiltration with triamcinolone.
