Idiopathic transient osteoporosis a rare and underdiagnosed entity a case report with a review of the literature

Introduction. Idiopathic transient osteoporosis of the hip is a rare but underdiagnosed condition. It is common in middle-aged men and pregnant women. The exact etiology is unknown. Aim. We present a 52-year-old man presented with progressively increasing pain left hip for two months. Description of the case. The radiograph showed osteoporosis localized to the proximal femur. Magnetic resonance imaging showed bone marrow edema. He was diagnosed as a case of idiopathic transient osteoporosis of the left hip (ITOH) after ruling out other causes. He was treated nonoperatively with analgesics and rest. He was given daily calcium and monthly ibandronate 150mg. His symptoms subsided after 3 months. There was no recurrence of symptoms. Conclusion. We present this case to describe the clinical, radiological features, diagnosis, and treatment of ITOH. Idiopathic transient osteoporosis is a rare condition. It is often not diagnosed because of a lack of awareness and also being a self-limiting condition. The radiogram may be normal. So a high index of suspicion is needed for its diagnosis.

Download Full-text

A RARE CAUSE OF PAIN IN THE MUSCULOSKELETAL SYSTEM: BONE MARROW EDEMA SYNDROME

Innovare Journal of Medical Sciences ◽

10.22159/ijms.2021.v9i3.41040 ◽

2021 ◽

pp. 10-11

Author(s):

ONUR DAĞDEVIREN ◽

EMINE TÜRKKAN ◽

HÜSEYIN DAĞ ◽

RECEP YILMAZ BAYRAKTARLI

Keyword(s):

Bone Marrow ◽

Musculoskeletal System ◽

Interstitial Fluid ◽

Bone Marrow Edema ◽

Rare Condition ◽

Resonance Imaging ◽

Adolescent Population ◽

Bone Marrow Edema Syndrome ◽

Cause Of Pain ◽

Marrow Edema

Bone marrow edema syndrome is characterized by increased interstitial fluid in the bone marrow and is a rare disease in children and adolescents. Therefore, to make this diagnosis, it should be considered in the differential diagnosis of musculoskeletal system pain. With this perspective, the aim was to present a 17-year-old patient who was diagnosed on magnetic resonance imaging with bone marrow edema and to highlight characteristics of this rare condition in the pediatric and adolescent population.

Download Full-text

Bursitis, adventitious bursa, localized soft-tissue inflammation, and bone marrow edema in tibial stumps: The contribution of magnetic resonance imaging to the diagnosis and management of mechanical stress complications

Archives of Physical Medicine and Rehabilitation ◽

10.1016/s0003-9993(03)04808-6 ◽

2003 ◽

Vol 84 (5) ◽

pp. 770-777 ◽

Cited By ~ 2

Author(s):

Anne Foisneau-Lottin ◽

No[euml ]l Martinet ◽

Philippe Henrot ◽

Jean Paysant ◽

Alain Blum ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Bone Marrow ◽

Magnetic Resonance ◽

Soft Tissue ◽

Mechanical Stress ◽

Bone Marrow Edema ◽

Resonance Imaging ◽

Tissue Inflammation ◽

Soft Tissue Inflammation ◽

Marrow Edema

Download Full-text

Hypertrophy of the abductor hallucis muscle: A case report and review of the literature

SAGE Open Medical Case Reports ◽

10.1177/2050313x17727638 ◽

2017 ◽

Vol 5 ◽

pp. 2050313X1772763 ◽

Cited By ~ 1

Author(s):

Toshinori Kurashige

Keyword(s):

Rare Case ◽

Muscle Hypertrophy ◽

Pathological Condition ◽

Rare Condition ◽

Review Of The Literature ◽

Resonance Imaging ◽

Abductor Hallucis ◽

Medial Plantar Nerve ◽

Abductor Hallucis Muscle ◽

Entrapment Syndromes

Objectives: Muscle hypertrophy is a relatively rare condition that may cause nerve entrapment syndromes. We report the case of a 14-year-old girl with unilateral hypertrophy of the abductor hallucis muscle with entrapment of the medial plantar nerve and review the literature. Methods: Computed tomography and magnetic resonance imaging revealed unilateral hypertrophy of the abductor hallucis muscle. Results: Two injections of steroid and lidocaine at the point of tenderness resulted in resolution of the pain. Conclusions: We report a rare case of hypertrophy of the abductor hallucis muscle considered with entrapment of the medial plantar nerve. Treatment of this condition should be selected according to the pathological condition of each patient.

Download Full-text

AB1100 PERFORMANCE OF MAGNETIC RESONANCE IMAGING FOR DETECTING SACROILIITIS IN EARLY STAGES OF SPONDYLOARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5137 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1839.1-1839

Author(s):

F. Ladeb ◽

D. Ben Nessib ◽

M. Bouaziz ◽

W. Hamdi ◽

E. Labbene ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Bone Marrow ◽

Magnetic Resonance ◽

Positive Predictive Value ◽

Bone Marrow Edema ◽

Resonance Imaging ◽

Sacroiliac Joints ◽

Early Stages ◽

The Mean ◽

Marrow Edema

Background:In view of the limited accuracy of clinical evaluation to recognize sacroiliitis, several imaging techniques such as conventional radiographs, scintigraphy, ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) have been used to examine the sacroiliac joints (SIJ).Objectives:The aim of this study was to assess the performance of MRI for detecting sacroiliitis in early stages of spondyloarthritis (SpA).Methods:This cross-sectional prospective monocentric double-blind study included 57 patients consulting for symptoms suggestive of SpA during more than 3 months between February 2014 and February 2017. Patients with conventional radiograph showing a confirmed sacroiliitis (grade 3 or 4) were not included. After clinical examination and blood sampling, eligible patients underwent MRI of SIJ. MR images were interpreted by 2 experimented musculoskeletal radiologists blinded to clinical and laboratory data. Two professors in rheumatology blinded to radiologists’ conclusions, analyzed clinical data, laboratory tests, HLA typing, X-rays and MRI images and divided the patients into 2 groups: confirmed non radiographic SpA (nr-SpA) or no SpA. This classification was considered as the gold standard when analyzing the results.Results:Fifteen men and 42 women were enrolled. The mean age at inclusion was 39.75 ± 11 years [17-59]. The mean duration from the first symptom was 47 ± 39 months [6.6-180]. Forty-three patients were assessed as nr-SpA (75.4%) and 14 patients as no SpA (24.6%). Thirty-three percent of patients were HLA B27 positive. Totally 22 patients had sacroiliitis at MRI, all of them classified as confirmed nr-SpA. Among the nr-SpA group, MRI showed bone marrow edema (BME) in 34.9% of patients and erosions in 44.2% of patients. Among the patients in whom the diagnosis of SpA was excluded, MRI showed bone marrow edema (BME) in 7% of patients and erosions in 7% of patients. A statistically significant association was observed between the presence of sacroiliitis at MRI and rheumatologists’ diagnosis of SpA (p=0.001). The diagnostic value of MRI lesions is presented in the following table:Sensitivity (%)Specificity (%)Positive Predictive Value (%)Positive Predictive Value (%)BME34.992.993.731.7Erosions44.292.99535.1MRI conclusion: sacroiliitis51.210010040Conclusion:SIJ MRI had an excellent specificity for the diagnosis of SpA but a moderate sensitivity. Consequently, some patients in early stages of SpA might be missed by MRI. In addition, we found that diagnostic based solely on BME lacked sensitivity. Detection of erosions in addition to BME enhanced sensitivity (from 34.9% to 44.9%) without changing specificity. Indeed, many recent studies have pointed out the importance of considering structural lesions of SIJ in addition to inflammatory lesions [1, 2].References:[1]Weber U, Lambert RGW, Pedersen SJ, et al (2010) Assessment of structural lesions in sacroiliac joints enhances diagnostic utility of magnetic resonance imaging in early spondylarthritis. Arthritis Care Res 62:1763–1771.https://doi.org/10.1002/acr.20312[2]Weber U, Jurik AG, Lambert RGW, Maksymowych WP (2016) Imaging in Spondyloarthritis: Controversies in Recognition of Early Disease. Curr Rheumatol Rep 18:58.https://doi.org/10.1007/s11926-016-0607-7Disclosure of Interests:None declared

Download Full-text

Perspective on Idiopathic Subchondral, Osteochondral, and Chondral Lesions with Emphasis on the Knee

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0039-1693978 ◽

2019 ◽

Vol 23 (05) ◽

pp. 534-546 ◽

Cited By ~ 1

Author(s):

Wolfgang Fischer

Keyword(s):

Magnetic Resonance Imaging ◽

Bone Marrow ◽

Bone Marrow Edema ◽

Osteochondrosis Dissecans ◽

Imaging Findings ◽

Resonance Imaging ◽

Chondral Lesions ◽

Everyday Work ◽

And Cartilage ◽

Marrow Edema

AbstractSubchondral, osteochondral, and chondral lesions of unknown cause are often encountered, especially in the knee joint. These are mainly idiopathic bone marrow edema syndrome, osteochondrosis dissecans, and cartilage delaminations. The literature on these diseases is sparse and often confusing and inconsistent. Because there is little evidence, this article was written as a perspective on these conditions. It offers an overview of the literature with personal comments and opinions based on observations from many years of clinical practice. The main goal is to highlight clinically important features and provide a practical guide for dealing with various magnetic resonance imaging findings in everyday work. The article also discusses several terms commonly used in relation to these diseases and their differential diagnoses.

Download Full-text

Calciphylaxis in a Patient With Non-Hodgkin Lymphoma: Case Report and Literature Review

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475418761867 ◽

2018 ◽

Vol 22 (5) ◽

pp. 524-526 ◽

Cited By ~ 1

Author(s):

Meggie Morand ◽

Myrna Chababi-Atallah ◽

Sara-Élizabeth Jean ◽

Carolina Fernandes

Keyword(s):

Systematic Review ◽

Hodgkin Lymphoma ◽

Rare Condition ◽

Skin Lesions ◽

Review Of The Literature ◽

End Stage Kidney Disease ◽

Cutaneous Lesions ◽

Non Hodgkin Lymphoma ◽

End Stage ◽

High Index Of Suspicion

Background: Calciphylaxis is a well-known entity in end-stage kidney disease and after renal transplant. Cases of nonuremic calciphylaxis (NUC) have also been reported, but data on this rare condition are mainly empirical. Objective: We discuss a case of NUC secondary to spontaneous tumour lysis syndrome in a patient who had chemotherapy for non-Hodgkin lymphoma and present a review of the literature to better characterize malignancy-associated NUC. Methods: We identified 12 published cases of malignancy-associated NUC. Results: This systematic review of malignancy-associated NUC did not show a relationship between the type of malignancy, the distribution of skin lesions, or mortality. However, distal more than proximal involvement seems to be more frequently associated with calcium phosphate imbalance. Conclusion: Clinicians must maintain a high index of suspicion for calciphylaxis when evaluating patients with cutaneous lesions developed in the setting of malignancy.

Download Full-text

Is bone marrow edema syndrome a precursor of hip or knee osteonecrosis? Results of 49 patients and review of the literature

Diagnostic and Interventional Radiology ◽

10.5152/dir.2020.19188 ◽

2020 ◽

Vol 26 (4) ◽

pp. 355-362

Author(s):

Tobias Geith ◽

◽

Ann-Cathrin Stellwag ◽

Peter E. Muller ◽

Maximilian Reiser ◽

...

Keyword(s):

Bone Marrow ◽

Bone Marrow Edema ◽

Review Of The Literature ◽

Bone Marrow Edema Syndrome ◽

Marrow Edema

Download Full-text

AN ACUTE FRACTURE OF THE FEMORAL NECK COMPLICATING BONE MARROW EDEMA IN OSTEONECROSIS OF THE FEMORAL HEAD, TREATED WITH TOTAL HIP REPLACEMENT

Journal of Musculoskeletal Research ◽

10.1142/s0218957710002417 ◽

2010 ◽

Vol 13 (01) ◽

pp. 39-42

Author(s):

Itay Fenichel ◽

Moshe Salai ◽

Steven Velkes

Keyword(s):

Bone Marrow ◽

Femoral Head ◽

Femoral Neck ◽

Total Hip Replacement ◽

Hip Replacement ◽

Bone Marrow Edema ◽

Transient Osteoporosis ◽

Total Hip ◽

Regional Migratory Osteoporosis ◽

Marrow Edema

Bone marrow edema is a sign that can be accompanied with osteonecrosis of the femoral head. There is still controversy as to whether it is a reversible form of avascular necrosis or it is a disease entity of its own. The probability and extent of the edema correlate well with the pain and stage of the necrosis. Unlike transient osteoporosis of the hip and regional migratory osteoporosis which are spontaneously resolving conditions, osteonecrosis can cause significant changes in the hip joint. We present a case of a displaced fracture of the femoral neck complicating bone marrow edema in osteonecrosis of the femoral head, in a 42-year-old man, treated with a cementless total hip replacement. This case emphasizes a potential complication associated with the state of diffuse bone marrow edema of the hip.

Download Full-text