Transient Primary Bone Marrow Edema Syndrome - A Synthesis
American Journal of Internal Medicine
Volume 7, Issue 2, March 2019, Pages: 27-32
Received: Mar. 4, 2019; Accepted: Apr. 4, 2019; Published: May 15, 2019
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Nissim Ohana, Department of Orthopeadic Surgery, Meir Medical Center, Kfar Saba and Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Dimitri Sheinis, Department of Orthopeadic Surgery, Soroka University Medical Center, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
Daniel Benharroch, 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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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.
Joint Pain, Bone Pain, Transient Bone Marrow Edema Syndrome, Systemic Osteoporosis, Migratory Osteoporosis, Bisphosphonates, Aledronate, Synthesis
To cite this article
Nissim Ohana, Dimitri Sheinis, Daniel Benharroch, Transient Primary Bone Marrow Edema Syndrome - A Synthesis, American Journal of Internal Medicine. Vol. 7, No. 2, 2019, pp. 27-32. doi: 10.11648/j.ajim.20190702.11
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This article is an open access article distributed under the Creative Commons Attribution License ( which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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