{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T17:10:05Z","timestamp":1745773805911,"version":"3.40.4"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Antiphospholipid syndrome (APS) is characterised by recurrent arterial and\/or venous thromboses and recurrent late miscarriages in the presence of antiphospholipid antibodies, and can be a hugely debilitating disorder. While the commonest thrombotic manifestations of this condition such as deep vein thrombosis and stroke are well documented, there has been increasing recognition of numerous less common complications in most organ systems. We present a female patient with APS and a lupus-like illness who had atraumatic sacral fractures as well as multiple spontaneous fractures affecting her ribs and the metatarsals in both her feet.<\/jats:p>","DOI":"10.1136\/bcr-2013-201311","type":"journal-article","created":{"date-parts":[[2013,10,31]],"date-time":"2013-10-31T00:34:25Z","timestamp":1383179665000},"page":"bcr2013201311","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Recurrent atraumatic metatarsal, rib and sacral insufficiency fractures in a woman with the antiphospholipid syndrome"],"prefix":"10.1136","volume":"2013","author":[{"given":"Joseph","family":"Villiers","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munther","family":"Khamashta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alastair","family":"Hepburn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,10,30]]},"reference":[{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.1","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1136\/bmj.287.6399.1088","article-title":"Thrombosis, abortion, cerebral disease, and the lupus anticoagulant","volume":"2013","author":"Hughes","year":"1983","journal-title":"BMJ"},{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.2","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1136\/ard.2003.016105","article-title":"Antiphospholipid antibodies, systemic lupus erythematosus, and non-traumatic metatarsal fractures","volume":"2013","author":"Sangle","year":"2004","journal-title":"Ann Rheum Dis"},{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.3","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1001\/archinte.166.2.241","article-title":"Risk of osteoporotic fracture in elderly patients taking warfarin: results from the National Registry of Atrial Fibrillation 2","volume":"2013","author":"Gage","year":"2006","journal-title":"Arch Intern Med"},{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.4","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.1002\/jbmr.253","article-title":"Atypical subtrochanteric and diaphyseal femoral fractures: report of a task force of the American Society for Bone and Mineral Research","volume":"2013","author":"Shane","year":"2010","journal-title":"J Bone Miner Res"},{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.5","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1172\/JCI2799","article-title":"Inhibition of osteoblastogenesis and promotion of apoptosis of osteoblasts and osteocytes by glucocorticoids: potential mechanisms of the deleterious effects on bone","volume":"2013","author":"Weinstein","year":"1998","journal-title":"J Clin Invest"},{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.6","doi-asserted-by":"crossref","first-page":"5592","DOI":"10.1210\/en.2006-0459","article-title":"Glucocorticoids act directly on osteoclasts to increase their lifespan and reduce bone density","volume":"2013","author":"Jia","year":"2006","journal-title":"Endocrinology"},{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.7","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.bone.2009.06.030","article-title":"Glucocorticoids, osteocytes and skeletal fragility: the role of the bone vascularity","volume":"2013","author":"Weinstein","year":"2010","journal-title":"Bone"},{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.8","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1172\/JCI31581","article-title":"The hypoxia inducible factor alpha pathway couples angiogenesis to osteogenesis during skeletal development","volume":"2013","author":"Wnag","year":"2007","journal-title":"J Clin Invest"},{"key":"2025042709333212000_2013.oct30_1.bcr2013201311.9","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1002\/art.10835","article-title":"Asymptomatic avascular necrosis in patients with primary antiphospholipid syndrome in the absence of corticosteroid use: a prospective study by magnetic resonance imaging","volume":"2013","author":"Tektonidou","year":"2003","journal-title":"Arthritis Rheum"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-201311","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T16:33:40Z","timestamp":1745771620000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-201311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,30]]},"references-count":9,"alternative-id":["10.1136\/bcr-2013-201311"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-201311","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,10,30]]}}}