Bilateral tibia and fibula fractures in a patient with rheumatoid arthritis

A 52-year-old woman with rheumatoid arthritis treated with low-dose steroid s developed bilateral distal tibia and fibula fractures over a 15-month per iod. Her bone density was within osteopenic levels. Such fractures are an u nusual but increasingly recognised complication of rheumatoid disease and i ts treatment, although there is often diagnostic delay. Bilateral fractures are particularly rare. A high level of clinical suspicion is required for early diagnosis.