Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D
10.11005/jbm.2019.26.4.241
- Author:
Sara PIEROPAN
1
;
Franco ANTONIAZZI
;
Elisa TADIOTTO
;
Federico CALDONAZZI
;
Maddalena MASCHIO
;
Giulia AIELLO
;
Giulia MELOTTI
;
Paolo CAVARZERE
;
Giorgio PIACENTINI
Author Information
1. Pediatric Clinic, Department of Life and Reproduction Sciences, Azienda Ospedaliera Universitaria Integrata, Verona Italy. elisatadiotto@yahoo.it
- Publication Type:Original Article
- Keywords:
Bone marrow oedema;
Child;
Magnetic resonance imaging;
Vitamin D
- MeSH:
Adolescent;
Ankle;
Bone Marrow;
Bone Remodeling;
Child;
Data Collection;
Diagnosis;
Foot;
Humans;
Immobilization;
Joints;
Magnetic Resonance Imaging;
Retrospective Studies;
Vitamin D Deficiency;
Vitamin D;
Vitamins
- From:Journal of Bone Metabolism
2019;26(4):241-246
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Bone marrow oedema (BMO) in children/adolescents is a rare clinical condition without an etiologic cause. It is associated with typical increased signal intensity on T2-weighted magnetic resonance images (MRI) and an increase in bone turnover in which vitamin D plays a pivotal role. No treatment guidelines for these young patients are to date available.METHODS: We performed a retrospective study in a pediatric setting of 13 patients with diagnosis of primary BMO of the foot on the basis of clinical and radiological findings. Data collection included sex, age, patient history, symptoms at presentation, clinical examination, laboratory bone turnover markers, vitamin D levels, MRI, treatment, and outcome.RESULTS: Vitamin D deficiency or insufficiency was found in 76.9% of cases. All patients were treated with adequate vitamin D daily intake, a short course of analgesic therapy, physical therapy, avoiding detrimental feet and ankle immobilization. All fully recovered in 3-month lag period.CONCLUSIONS: Our data highlight that environmental factors, such as underestimated articular or bone microtraumatisms, as well as joint hyper mobility, in a bone turnover milieu of vitamin D deficiency could be the cause of this clinical conditions. Adequate vitamin D supplementation, associated with physical and analgesic therapy, is crucial in the management of BMO.
