Bisphosphonate induced atypical proximal femoral fracture: “double edge dagger” radiological and scintigraphy findings

Bisphosphonate therapy has been an established and effective therapeutic option to prevent osteoporotic hip and other fractures but undeniable plethora of side effects ranging from esophagitis, iritis, jaw necrosis and atypical femoral fractures. AFFs are not very common but present pain, incomplete insufficiency fracture to complete fracture. These fractures have higher tendency of delayed union or non-union due to bisphosphonate induced reduced bone remodeling. So beyond any doubt benefits of bisphosphonate outweigh its risks but one should not forget it is a “Double Edge Dagger”.