A 78-year-old woman with arthralgias in her hands and feet that later also appear in her spine.
She received treatment with different drugs (including: indomethacin, tramadol and paracetamol), and analgesic treatment with beta blockers, which had to be discontinued due to leukopenia.
Table 1 shows the results of dual x-ray diffraction (DEXA) diagnosed in 2001, and is treated with calcium, vitamin D and bisphosphonates (rised for several years).
1.
In May 2012, treatment with Prolia® (denosumab) 60 mg every 6 months was started.
In December 2012, the patient underwent an extraction of which he suffered an infection, among the antibiotics with which he was treated we found amoxicillin/clavulanic acid, clindamycin and spiramycin.
After 6 months (July 2013) he began again with pain, objectifying for a second time infection, so his dentist referred him to the maxillofacial surgery service.
Due to the poor healing of the wound, it was decided to perform a facial and mandibular computed tomography in which a residual cyst was visualized at the level of 35 of 6 x 5 mm, with bone defect in the oral cortical.
anti-rheumatic drugs and anti-rheumatic drugs were discontinued immediately (in August 2013).
