PURPOSE OF REVIEW This article summarizes the risk factors for atypical femur fractures (AFF), discusses current and emerging imaging modalities for early identification of AFF, and offers recommendations for prevention and management of AFFs based on the current concepts. RECENT FINDINGS Antiresorptive therapies are widely recommended for prevention and treatment of osteoporosis. Despite their well established effectiveness to reduce fracture risk, emerging concerns related to potential adverse effects have led to a substantial decline in the use of bisphosphonates. Although, the pathogenesis of AFF has not yet been elucidated, the bulk of evidence supports that the well known therapeutic benefits of bisphosphonate far outweigh the relatively low risk of AFFs. Recommendations for early identification of patients at risk for AFF using radiographic imaging have been established. Consensus on the management of AFF and osteoporosis in patients with AFF needs to be formulated. SUMMARY AFF is a rare event associated with long-term bisphosphonate therapy, which represents an apparent paradox in the management of osteoporosis. Improved understanding of pathogenetic mechanisms will be helpful in further refining of screening guidelines and standardization of management and treatment strategies.

中文翻译：

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非典型股骨骨折的检测和处理。

综述目的 本文总结了非典型股骨骨折 (AFF) 的危险因素，讨论了早期识别 AFF 的当前和新兴影像学方法，并根据当前概念为 AFF 的预防和管理提供了建议。近期发现 抗吸收疗法被广泛推荐用于预防和治疗骨质疏松症。尽管它们在降低骨折风险方面具有公认的有效性，但与潜在不良反应相关的新问题已导致双膦酸盐的使用大幅下降。尽管 AFF 的发病机制尚未阐明，但大量证据支持双膦酸盐众所周知的治疗益处远远超过 AFF 的相对低风险。已经建立了使用放射成像早期识别有 AFF 风险的患者的建议。需要就 AFF 患者的 AFF 和骨质疏松症的管理达成共识。总结 AFF 是与长期双膦酸盐治疗相关的罕见事件，这代表了骨质疏松症管理中的一个明显矛盾。提高对发病机制的了解将有助于进一步完善筛查指南以及管理和治疗策略的标准化。