A case of adult hypophosphatasia involving a patient with recurrent bilateral metatarsal fractures is presented. This disorder, although relatively uncommon, is often associated with multiple pseudofractures and complete pathologic fractures of the lower extremity. It can be detected with routine laboratory analysis. Metabolic bone disease should be considered as a possible causative factor in patients with multiple “stress” fractures of the foot.
Get full access to this article
View all access options for this article.
References
1.
AndertonJ.M.Orthopaedic problems in adult hypophosphatasia. a report of two cases. J Bone Joint Surg., 61B: 82–84, 1979.
2.
BethuneJ.E.DentC.E.Hypophosphatasia in the adult. Am. J. Med., 28: 615–622, 1960.
3.
CoeJ.D.MurphyW.A.WhyteM.P.Management of femoral fractures and pseudofractures in adult hypophosphatasia. J. Bone Joint Surg., 68A: 981–990, 1986.
EisenbergE.PimstoneB.Hypophosphtaasia in an adult: a case report. Clin. Orthop., 52: 199–212, 1967.
6.
FaasF.H.WadkinsC.L.DanielsJ.S.DavisG.R.CarterW.J.WynnJ.O.Hyperparathyroidism in an elderly adult with hypophosphatasia. Clin. Orthop., 101: 216–219, 1974.
7.
FallonM.D.TeitelbaumS.L.WeinsteinR.S.GoldfischerS.BrownD.M.WhyteM.P.Hypophosphatasia: clinicopathologic comparison of the infantile, childhood, and adult forms. Medicine, 63: 12–24, 1984.
8.
JardonO.M.BurneyD.W.FinkR.L.Hypophosphatasia in an adult. J. Bone Joint Surg., 52A: 1477–1484, 1970.
9.
MaceyH.B.Multiple pseudofractures: report of a case. Proc. Staff Meet. Mayo Clin., 15: 789–791, 1940.
10.
RiggsL.B.MeltonL.J.Osteoporosis. Etiology, Diagnosis, and Management. New York, Raven Press, 1988.
11.
WhyteM.P.MurphyW.A.FallonM.D.Adult hypophosphatasia with chondrocalcinosis and arthropathy: variable penetrance of hypophosphatasemia in a large Oklahoma kindred. Am. J. Med., 72: 631–641, 1982.
12.
WhyteM.P.MahurenJ.D.VrabelL.A.CoburnS.P.Markedly increased circulating pyroxidal-5′-phosphate levels in hypophosphatasia. alkaline phosphatase acts in vitamin B6 metabolism. J. Clin. Invest., 76: 752–756, 1985.
13.
WhyteM.P.TeitelbaumS.L.MurphyW.A.BergfeldM.A.AvioliL.V.Adult hypophosphatasia: clinical, laboratory, and genetic investigation of a large kindred with review of the literature. Medicine, 58: 329–347, 1979.
