Introduction: Pregnancy- and lactation-associated osteoporosis (PLAO) is a rare cause of back pain during pregnancy and puerperium. We report a rare case of PLAO with subchondral fracture of the femoral head.
Case report: A 19-year-old second gravida presented with severe back pain and an inability to ambulate due to pain in the right buttock during the puerperium. The pain started during the last trimester and was aggravated after delivery. Her radiogram showed multiple compression fractures with osteopenia in the dorsolumbar spine. A magnetic resonance imaging scan of the pelvis showed bone marrow edema with subchondral fracture involving the right femoral head. A diagnosis of PLAO was made thorough investigations and excluding other possibilities.
Conclusion: PLAO is a rare cause of back pain. Subchondral fracture of the femoral head is an extremely rare occurrence in PLAO. A high index of suspicion is needed for its diagnosis. Early diagnosis and treatment are essential to avoid complications such as vertebral fractures.
Keywords: Osteoporosis; back pain in pregnancy; pregnancy- and lactation-associated osteoporosis; subchondral fracture of the femoral head.
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