Affiliations 

  • 1 Department of Orthopaedic, Hospital Sultan Ismail, Johor Bharu, Johor Darul Ta'zim, Malaysia
  • 2 Department of Orthopaedics, Penang General Hospital, Georgetown, Pulau Pinang, Malaysia
  • 3 Orthopaedic Surgery, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia drkmgohn@ums.edu.my
  • 4 Department of Pathology, Hospital Queen Elizabeth, Kota Kinabalu, Sabah, Malaysia
BMJ Case Rep, 2024 Feb 22;17(2).
PMID: 38388204 DOI: 10.1136/bcr-2023-258973

Abstract

Spinal involvement in primary amyloidosis is an exceedingly rare condition, presenting with typical pathological fracture symptoms that are often indistinguishable from other pathologies such as bone metastasis, metabolic disorders and infections. Histopathological studies for tissue diagnosis are the cornerstone of a definitive diagnosis, leading to successful treatment. Early diagnosis and intervention play a pivotal role in the care of patients with amyloidosis. Here, we present a unique case of a pathological fracture in the L4 vertebra following minor trauma. This fracture manifested with pain, instability and limitations in daily activities in a patient who had already been diagnosed with systemic amyloidosis and was undergoing chemotherapy. This case represents a distinct instance of vertebral involvement in amyloidosis and was managed with both chemotherapy and surgical intervention to address the spinal pathology, resulting in favourable outcomes.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.