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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 9, 1249-1251.
doi: 10.1302/0301-620X.91B9.22276  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Simultaneous osteonecrosis and osteomyelitis in a patient with cancer of the breast

K.-Y. Huang, MD, Orthopaedic Surgeon, Assistant Professor1; R.-S. Yang, MD, PhD, Orthopaedic Surgeon, Professor2; and C.-C. Hsieh, MD, Diagnostic Radiologist3

1 Department of Orthopaedics and Institute of Clinical Medicine, College of Medicine
2 Department of Orthopaedics, College of Medicine, National Taiwan University Medical Center, No. 7 Chung-Shan South Road, Taipei 10043, Taiwan.
3 Department of Radiology, National Cheng Kung University Hospital, Tainan, Taiwan No. 138 Sheng Li Road, Tainan City 70428, Taiwan.

Correspondence should be sent to Dr C.-C. Hsieh; e-mail: goba.goba{at}msa.hinet.net

Breast cancer is generally managed surgically with adjuvant agents which include hormone therapy, chemotherapy, radiotherapy and bisphosphonate therapy. However, some of these adjuvant therapies may cause adverse events, including wound infection, neutropenia, bone marrow suppression and fever. The simultaneous presentation of osteonecrosis and osteomyelitis has not previously been described in patients with breast cancer undergoing hormone therapy and chemotherapy.

We report a patient with breast cancer who developed bone infarcts in both legs as well as osteomyelitis in the right distal tibia after treatment which included a modified radical mastectomy, hormone therapy and chemotherapy. Simultaneous osteonecrosis and osteomyelitis should be considered in patients with breast cancer who are receiving chemotherapy and hormone therapy who present with severe bone pain, especially if there have been infective episodes during treatment.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General