Print Email
 

Clinical Images

Dead Bone Walking

February 9, 2016

A 65-year-old male presented with pain in the left lower jaw of one-month duration. His past medical history was significant for multiple myeloma, and he had undergone autologous stem cell transplantation 6 months prior. His current treatment regimen included lenalidomide, steroids, and monthly zoledronic acid injections. The pain was progressive and associated with a low-grade fever. On examination he was noted to have a tender left lower jaw with mild swelling and erythema of the overlying skin. Halitosis and trismus were also noted. Exam of the mouth showed carious teeth and multiple edentulous sockets. A purulent sinus was noted on the lingual aspect of the left mandibular alveolus in an edentulous socket. Submandibular tender lymphadenopathy was noted as well. A roentgenogram of the mandible was obtained (Figure 1). 

 

dead bone



Click here to view answer

References:
1. Rodan GA, Reszka AA. Bisphosphonate mechanism of action. CurrMol Med. 2002 Sep. 2(6):571-7. 
2. Ruggiero SL. Guidelines for the diagnosis of bisphosphonate-related osteonecrosis of the jaw. Clin Cases Miner Bone Metab. 2007 Jan-Apr; 4(1): 37–42.


Authors:
1. Khalid Hamid Changal. MBBS, MD Internal Medicine Sher-i-Kashmir Institute of Medical Sciences Srinagar, India. Senior Resident. khalidchangal@gmail.com 
2. Rehana Bashir. BDS, MDS Orthodontics, Institute of Dental Studies & Technologies, Meerut, India.  Resident.
3. Manzoor Parray. MBBS, MD Internal Medicine Sher-i-Kashmir Institute of Medical Sciences Srinagar, India. Senior Resident.  

 

 



 

Submit content to JGIM

JGIM encourages submission of articles aimed at improving patient care, education, and research in primary care and general internal medicine in all settings. Submissions must be original and not currently under consideration for publication in another peer- reviewed medium (paper or electronic).

Learn How to Submit Here

 

FEATURED ARTICLE

 

Darlyn Victor, MD, Paul Moots, MD and Jacqueline Fischer, MD

October 13, 2016

A 39-year-old African-A....

Read Article
 

Most Viewed Articles

73 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
25 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
31 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF

Most Recent Web Only Content

January

17

On the Penetrating Capacity of Ultrasound

Sarah Bugg

Read Article

December

20

Painful Eruption in a Mountain Biker

Jasna Ikanovic, MD and Animita Saha, MD

Read Article

November

19

Adverse Events In US Hospitals:1 in 3 Admissions Has At Least One Adverse Event

SGIM Evidence-Based Medicine Task Force

Read Article

August

25

Diagnostic Schema

Denise M. Connor, Rabih Geha, Mark Henderson, Jeff Kohlwes

Read Article