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Methotrexate-induced osteopathy is a rare complication seen mainly in postmenopausal women with rheumatoid or psoriatic arthritis. It predominantly manifests as atraumatic stress fractures localized to the lower limbs, particularly the tibia and foot. Early and precise diagnosis using MRI or bone scintigraphy improves clinical identification. Discontinuation of methotrexate significantly enhances patient outcomes, highlighting the need for careful clinical vigilance despite methotrexate’s established therapeutic benefits.
