Transient osteoporosis of the navicular bone in a runner
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Transient osteoporosis or the bone marrow oedema syndrome is described as a self-limiting disorder. Transient osteoporosis usually affects only one bone, predominantly the proximal femur. Involvement of the foot is rare and often overlooked. A disorder of the navicular bone of the foot can be found twice in the literature.
Materials and methods
We report a case of transient osteoporosis of the navicular bone of the foot in a 20-year-old, female, top-level track athlete (400 m sprinter) treated with alendronate, and a review of the literature.
The therapeutic options are limited, frequently consisting of non-specific, symptomatic therapy. Some authors report favourable results with core decompression, while others have reported good results with a conservative regime of symptomatic treatment and avoidance of weight-bearing until the clinical and radiological changes have resolved. In the described case, the patient had a favourable result after a short course of treatment with alendronate. She experienced almost immediate pain reduction and presented a complete resolution of the abnormal signal intensity on MRI.
This rapid result makes the use of alendronate seem promising in athletes with transient osteoporosis, permitting an early return to high-level activities.
KeywordsTransient osteoporosis Navicular bone Biphosphonate
- 2.Berenson JR, Lichtenstein A, Poerter L, Dimopolous MA, Bordoni R, George S, Lipton A, Keller A, Ballester O, Kovacs MJ, Blacklock HA, Bell R, Simeone J, Reitsma DJ, Heffernan M, Seaman J, Knight RD (1996) Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma. N Engl J Med 334:488–493CrossRefPubMedGoogle Scholar
- 3.Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer C, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Lancet 348:1535–1541PubMedGoogle Scholar
- 4.Bramlett KW, Killian JT, Nasca RJ, Daniel WW (1987) Transient osteoporosis. Clin Orthop 222:197–202Google Scholar
- 6.Curtiss PH, Kincaid WE (1959) Transitory demineralisation of the hip in pregnancy: a report of three cases. J Bone Joint Surg Am 41:1327–1333Google Scholar
- 7.Diel IJ, Solomayer EF, Costa SD, Gollan C, Goerner C, Wallwiener D, Bastert G (1998) Reduction in new metastases in breast cancer with adjuvant clodronate treatment. N Engl J Med 339:357–363Google Scholar
- 8.Doury P(1980) Regional osteoporosis of the hip treated with calcitonin continued. J Rheumatol 7:114–116Google Scholar
- 13.Gallant GG, Fischer RL, Sziklas J (1994) Transient regional osteoporosis of the ankle and foot. A report of four cases and review of the literature. Orthop Rev. 23:405–409Google Scholar
- 17.Hofmann S, Kramer J, Schneider W, Plenh H (1997) Transient osteoporosis may represent a reversible early form of avascular necrosis of the hip joint. Curr Orthop 11:164–172Google Scholar
- 19.Hortobagyi GN, Theriault RL, Porter L, Porter L, Blayney D, Sinoff C, Wheeler H, Simeone JF, Seaman JJ, Knight RD, Heffeman M, Mellars K, Reitsman DJ (1998) Efficiacy of pamidronate in reducing skeletal complications in patients with breast cancer and lytic bone metastases. N Engl J Med 335:1785–1791CrossRefGoogle Scholar