Transient Osteoporosis of the Talus

Abstract

Transient osteoporosis is a clinical syndrome of unknown etiology characterized by the acute onset of pain gradually worsening over several weeks to months. Radiographic changes occur, but laboratory studies are generally unremarkable. Transient osteoporosis of the talus appears to have a similar clinical appearance, radiographic findings, and successful response to conservative management as transient osteoporosis found elsewhere in the body and can be treated similarly. Awareness of this syndrome is important to avoid confusing it with a variety of other disorders of the talus that may have similar clinical presentations.

Bilateral transient osteoporosis of the talus in pregnancy

“…Although considered rare, TOH is a wellestablished complication of the late second to early third trimester of pregnancy [2]. Transient osteoporosis has rarely been reported to affect the knees, but previous documentation of talar involvement has been sparser [3][4][5][6][7][8].…”

“…Some authors speculate that the true incidence of TO may be grossly underappreciated as arthralgia and musculoskeletal discomfort are often considered normal complaints during pregnancy [2]. TO is more common in two unique populations: men in their fourth and fifth decades of life and young women in the third trimester of pregnancy [5,9]. In both groups, TO is usually unilateral, but bilateral disease has been reported [2,9,[11][12][13].…”

Transient bone marrow oedema of the foot

“…This was also confirmed in our study. Since TBME is a reversible disease, symptomatic treatment with non-steroid anti-inflammatory drugs and limited weight bearing is considered to be the treatment of choice [17]. Only CD is able to shorten the natural course of disease, which Hofmann et al [13] was the first to observe in patients with TBME of the hip.…”

“…TBME of the talus [4,17] is rare. In our study there were however eight patients with TBME of the talus.…”

“…TBME usually affects one bone, mainly the proximal femur [2]. Reports describing an involvement of the foot, particularly the talus, are rare [4,17]. Nevertheless TBME is an important differential diagnosis of foot and ankle pain of acute onset.…”