Journal of Orthopaedics and Traumatology

Official Journal of the Italian Society of Orthopaedics and Traumatology

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Open Access

A new hypothesis for the bone marrow edema pathogenesis during transient osteoporosis

  • G. Negri1Email author,
  • S. Grassi1,
  • M. Zappia2,
  • S. Cappabianca2,
  • P. F. Rambaldi3 and
  • L. Mansi3
Journal of Orthopaedics and TraumatologyOfficial Journal of the Italian Society of Orthopaedics and Traumatology20067:144

https://doi.org/10.1007/s10195-006-0144-6

Received: 28 February 2006

Accepted: 1 November 2006

Published: 18 December 2006

Abstract

Transient osteoporosis is an infrequent condition of uncertain etiology with pain, limited range of motion and radiographic evidence of osteoporosis affecting one or more joints. It is self-limited, reversible and can involve only the hip (transient osteoporosis of the hip, TOH) or, less frequently, one or more joints contemporaneously or at different times (regional migratory osteoporosis, RMO). We studied four men with transient osteoporosis, including two with TOH and two with RMO. All patients underwent a standard radiographic work-up of the affected joints, arteriovenous Doppler US, computed tomography, magnetic resonance imaging (MRI) and three-phase bone scanning. In all patients, symptoms were related to bone marrow edema demonstrated at MRI and to a transitory regional arterial hyperflow observed at the early scintigraphic analysis. On the basis of our observations, we hypothesize that regional arterial hyperflow may be the cause of the bone marrow edema and therefore of the transient osteoporosis.

Key words

Arterial hyperflow Bone marrow edema Regional migratory osteoporosis Transient osteoporosis

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