Atypical Fracture With Use of Ibandronate and the Role of Bone Scintigraphy on its Early Diagnosis
Bibliographic record
Abstract
We report a case of a 49 year-old woman with osteoporosis in treatment with sodium ibandronate 150 mg per week for 5 years that presented leg and knees pain, causing her to stop physical activities. There were no alterations on the physical examination or on plain radiography of legs. A bone scintigraphy with technetium-99m (99mTc) methylene diphosphonate showed a high uptake on the medial third of both femurs and 20 days later, while walking on the street, she fractured her right femur on the position listed above. Even though it is uncommon, bisphosphonates can predispose atypical fractures after a long time of use. It is difficult, though, to predict which patients are going to develop it. This case brings up the question whether bone scintigraphy could be useful as an exam to the early diagnose of atypical fractures on patients using bisphosphonates for a long period of time. doi: http://dx.doi.org/10.4021/jem166w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".