TRANSIENT MIGRATORY OSTEOPOROSIS
or, IDIOPATHIC TRANSIENT OSTEOPOROSIS
or, BONE MARROW OEDEMA SYNDROME
- Definition: An acute condition of unknown etiology characterized by severe pain in hip, mainly found in middle aged men & less often in women of late pregnancy.
- Etiology: Unknown
- Site: Most common- Hip joint, then Ankle, Foot & Knee.
- B/L- 30%
- Pathophysiology: Sub-lethal reversible episode of ischemia associated with hyperemia of surrounding bone.
- Clinical Features: ~Acute onset of Hip pain, Limp, Local muscle wasting
~Pain migrating to ankle, foot or knee;
~No H/O Trauma
~Slowly resolving after 4-6 months.
- X-RAY: Demineralization of Head & Neck
- Bone Scan: Increased activity
1)Diffuse– Bone oedema;
2)Focal– Focal lesion in the zone of greatest bone strain; after 3 months of diffuse form &
3)Residual– resolving; intensity of normal fatty marrow; small residual lesion in head/neck
- D/D: Osteonecrosis, Osteomyelitis, Neoplasm, PVNS, RA etc.
- Treatment: Rest +/- Analgesics
>resolves in 6 months
Role of Bisphosphonates in some cases.
Core decompression if no relief in pain.