American Journal of Internal Medicine

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Transient Primary Bone Marrow Edema Syndrome - A Synthesis

Received: 04 March 2019    Accepted: 04 April 2019    Published: 15 May 2019
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Abstract

A complex and often confusing nomenclature is currently used for relatively rare syndromes characterized by sudden onset of joint pain in the lower limbs, absence of trauma, bone marrow edema and its resolution, both confirmed by the MRI, as well as a self-limiting course. These include transient osteoporosis of the hip (TOH), of the knee (TOK), of the foot and ankle and transient bone marrow edema syndrome. Our purpose was to review the literature in order to substantiate the hypothesis that these apparently different conditions may be synthesized into a single disease entity, termed transient primary bone marrow edema syndrome (TPBMES). Of a total of 546 patients scrutinized, 342 had TOH, 105 had TOH of pregnancy, and 49, mainly females, showed transient foot-and-ankle osteoporosis. TPBMES occurred also with systemic osteoporosis or in a migratory pattern. The six proposed subsets of TPBMES have in common a MRI-based diagnosis and remission, as well as a self-limiting course. Thus, the hypothesis of a single disease entity is sustainable. We conclude that the education of the medical profession regarding this rare disease should expand. The causes of the prolonged symptoms seen in the systemic osteoporosis and migratory subsets warrant further studies. The efficiency of our suggested modality of management should be validated in a large cohort.

DOI 10.11648/j.ajim.20190702.11
Published in American Journal of Internal Medicine (Volume 7, Issue 2, March 2019)
Page(s) 27-32
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Joint Pain, Bone Pain, Transient Bone Marrow Edema Syndrome, Systemic Osteoporosis, Migratory Osteoporosis, Bisphosphonates, Aledronate, Synthesis

References
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[3] Geith T, Niethammer T, Milz S, Dietrich O, Reiser M, Baur-Melnyk A. Transient bone marrow edema syndrome versus osteonecrosis: perfusion patterns at dynamic contrast-enhanced MR imaging with high temporal resolution can allow differentiation. Radiology2017;283:478-485.
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[6] Singh D, Ferrero A, Rose B, Goldberg A, Cullen N. Bone marrow edema syndrome of the foot and ankle. Foot & Ankle Specialist 2016;9:218-226.
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[16] Horas K, Fraissler L, Maier G, et al. High prevalence of Vitamin D deficiency in patients with bone marrow edema syndrome of the foot and ankle. Foot & Ankle Int 2017;38:760-766.
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[18] Emad Y, Ragab Y, El-Shaarawy N, Rasker JJ. Transient osteoporosis of the hip, complete resolution after treatment with aledronate as observed by MRI description of eight cases and review of the literature. ClinRheumatol 2012;31:1641-1647.
[19] Flores-Robles BJ, Sanz-SanzJ, Sanabria-Sanchinel AA. Zoledronic acid treatment in primary bone marrow edema syndrome. J Pain Palliat Care Pharmacother2017; 31:52-56.
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Author Information
  • Department of Orthopeadic Surgery, Meir Medical Center, Kfar Saba and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

  • Department of Orthopeadic Surgery, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel

  • Independent Physician, Department of Pathology, Soroka University Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel

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  • APA Style

    Nissim Ohana, Dimitri Sheinis, Daniel Benharroch. (2019). Transient Primary Bone Marrow Edema Syndrome - A Synthesis. American Journal of Internal Medicine, 7(2), 27-32. https://doi.org/10.11648/j.ajim.20190702.11

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    ACS Style

    Nissim Ohana; Dimitri Sheinis; Daniel Benharroch. Transient Primary Bone Marrow Edema Syndrome - A Synthesis. Am. J. Intern. Med. 2019, 7(2), 27-32. doi: 10.11648/j.ajim.20190702.11

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    AMA Style

    Nissim Ohana, Dimitri Sheinis, Daniel Benharroch. Transient Primary Bone Marrow Edema Syndrome - A Synthesis. Am J Intern Med. 2019;7(2):27-32. doi: 10.11648/j.ajim.20190702.11

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  • @article{10.11648/j.ajim.20190702.11,
      author = {Nissim Ohana and Dimitri Sheinis and Daniel Benharroch},
      title = {Transient Primary Bone Marrow Edema Syndrome - A Synthesis},
      journal = {American Journal of Internal Medicine},
      volume = {7},
      number = {2},
      pages = {27-32},
      doi = {10.11648/j.ajim.20190702.11},
      url = {https://doi.org/10.11648/j.ajim.20190702.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ajim.20190702.11},
      abstract = {A complex and often confusing nomenclature is currently used for relatively rare syndromes characterized by sudden onset of joint pain in the lower limbs, absence of trauma, bone marrow edema and its resolution, both confirmed by the MRI, as well as a self-limiting course. These include transient osteoporosis of the hip (TOH), of the knee (TOK), of the foot and ankle and transient bone marrow edema syndrome. Our purpose was to review the literature in order to substantiate the hypothesis that these apparently different conditions may be synthesized into a single disease entity, termed transient primary bone marrow edema syndrome (TPBMES). Of a total of 546 patients scrutinized, 342 had TOH, 105 had TOH of pregnancy, and 49, mainly females, showed transient foot-and-ankle osteoporosis. TPBMES occurred also with systemic osteoporosis or in a migratory pattern. The six proposed subsets of TPBMES have in common a MRI-based diagnosis and remission, as well as a self-limiting course. Thus, the hypothesis of a single disease entity is sustainable. We conclude that the education of the medical profession regarding this rare disease should expand. The causes of the prolonged symptoms seen in the systemic osteoporosis and migratory subsets warrant further studies. The efficiency of our suggested modality of management should be validated in a large cohort.},
     year = {2019}
    }
    

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    T1  - Transient Primary Bone Marrow Edema Syndrome - A Synthesis
    AU  - Nissim Ohana
    AU  - Dimitri Sheinis
    AU  - Daniel Benharroch
    Y1  - 2019/05/15
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    DO  - 10.11648/j.ajim.20190702.11
    T2  - American Journal of Internal Medicine
    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    PB  - Science Publishing Group
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    AB  - A complex and often confusing nomenclature is currently used for relatively rare syndromes characterized by sudden onset of joint pain in the lower limbs, absence of trauma, bone marrow edema and its resolution, both confirmed by the MRI, as well as a self-limiting course. These include transient osteoporosis of the hip (TOH), of the knee (TOK), of the foot and ankle and transient bone marrow edema syndrome. Our purpose was to review the literature in order to substantiate the hypothesis that these apparently different conditions may be synthesized into a single disease entity, termed transient primary bone marrow edema syndrome (TPBMES). Of a total of 546 patients scrutinized, 342 had TOH, 105 had TOH of pregnancy, and 49, mainly females, showed transient foot-and-ankle osteoporosis. TPBMES occurred also with systemic osteoporosis or in a migratory pattern. The six proposed subsets of TPBMES have in common a MRI-based diagnosis and remission, as well as a self-limiting course. Thus, the hypothesis of a single disease entity is sustainable. We conclude that the education of the medical profession regarding this rare disease should expand. The causes of the prolonged symptoms seen in the systemic osteoporosis and migratory subsets warrant further studies. The efficiency of our suggested modality of management should be validated in a large cohort.
    VL  - 7
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