Bilateral transient osteoporosis of the knee during pregnancy

Abstract

Transient osteoporosis is a rare disease, which can affect pregnant women in the third trimester. Bone marrow edema syndrome, transient bone demineralization, hip algodystrophy, regional migratory osteoporosis, and even reflex sympathetic dystrophy all are terms that have been used to describe the condition. Babinsky and Fromen first documented the symptoms of transient osteoporosis in 1916, and in 1959 Curtiss and Kincaid discussed two cases affecting women in the third trimester of pregnancy. The hip joints are most commonly affected in pregnant women, being reported in 76 % of cases.

Migratory transient osteoporosis: atypical migration to the bilateral knee after childbirth

“…[7] Although particularly seen in pregnant women during the third trimester, it may also be detected in young men. [7][8][9] The hip joint is most frequently affected (76%).…”

“…[7] Although particularly seen in pregnant women during the third trimester, it may also be detected in young men. [7][8][9] The hip joint is most frequently affected (76%). [10] This is followed by lower extremity joints such as knee, ankle and foot joints.…”

“…[11] Bilateral knee involvement, as in our case is quite rare and only three cases were reported prior to this case report. [3,5,7] The pathogenesis of the disorder is still not clear. Genetic predisposition, local circulatory disorders, compression of obturator nerve, medullary hypertension of bone, small vessel ischemia, subperiosteal and subchondral fat embolism and pregnancy-related hormonal factors are implicated etiologically.…”

Musculoskeletal problems in pregnancy

“…Though hip is the most often involved joint, increasingly osteoporosis of knee and talus is also being reported [25,26]. Transient osteoporosis of the hip (TOH) presents acutely in the third trimester of an otherwise normal pregnancy.…”

Transient regional osteoporosis

“…The original description defined the process as transient osteoporosis of the hip (TOH) during pregnancy [3]. The succeeding case reports revealed that TOH may be bilateral [4][5][6][7][8][9][10][11][12] and that may affect not only the hip, but also other joints in the lower extremities, like knee or ankle [13][14][15]. Moreover, it soon became clear that cases were not restricted to pregnancy [16][17][18], or even to women, since the disease was also observed in men, usually in their fifties or sixties [19][20][21].…”