PT - JOURNAL ARTICLE AU - Venthan Jeyaratnam Mailoo AU - Vidya Srinivas AU - Jeremy Turner AU - William Duncan Fraser TI - Beware of bone pain with bisphosphonates AID - 10.1136/bcr-2018-225385 DP - 2019 Mar 01 TA - BMJ Case Reports PG - e225385 VI - 12 IP - 3 4099 - http://casereports.bmj.com/content/12/3/e225385.short 4100 - http://casereports.bmj.com/content/12/3/e225385.full SO - BMJ Case Reports2019 Mar 01; 12 AB - A 71-year-old woman who had been taking ibandronate for 10 years presented to an Endocrinology Department with persistent mid-thigh pain. Pelvic X-ray showed bilateral femoral cortical expansion, indicating impending atypical femoral fractures (AFFs). AFFs have been linked to long-term bisphosphonate therapy and have morbidity and mortality similar to that of hip fractures. Such fractures can be averted by regular reviews of bisphosphonate therapy and vigilance for prodromal symptoms. This patient’s bisphosphonate therapy was stopped, and fractures were avoided by treatment with vitamin D and parathyroid hormone.