Atypical metatarsal fracture in a Chinese postmenopausal woman with osteoporosis on long-term denosumab: a case report

Case presentationWe report the first case of atypical fifth metatarsal fracture in a 69-year-old Chinese woman following long-term treatment for osteoporosis with denosumab.She had been diagnosed with hypertension in 2007 and was managed with amlodipine and losartan.One year previously in 2006, she had been diagnosed with postmenopausal osteoporosis based on low bone mineral density (BMD) revealed at a health screening.Her height and weight were 150 cm and 54 kg, respectively, with a body mass index of 24.0 kg/m 2 .She had no previous history of fracture or parental history of hip fracture.The patient was initially prescribed raloxifene for 2 years but due to a suboptimal BMD response, she was treated with alendronate for 4 years.Given the prolonged use of alendronate, she was switched