Regional Transient Osteoporosis of the Foot and Vitamin C Deficiency

Overview

Journal Clin Rheumatol

Publisher Springer

Specialty Rheumatology

Date 2006 Mar 16

PMID 16538389

Citations 2

Authors

Sandra Rodriguez

Oscar Paniagua

Kenneth M Nugent

Michael P Phy

Affiliations

Soon will be listed here.

Abstract

We describe the clinical presentation and diagnostic tests of a patient with regional transient osteoporosis (RTO) of the foot. This patient presented with a 4-month history of left-foot pain, nonpitting edema, and brownish discolorations of both feet. He had a history of tobacco abuse, alcohol abuse, and malnutrition. Radiological studies revealed severe osteopenia in the feet, and a MRI revealed bone marrow edema. The bone biopsy was consistent with RTO. This patient also had vitamin C deficiency. This case suggests a link between vitamin C deficiency and RTO, a hypothesis supported by our review of relevant literature on osteoporosis and vitamin C.

Citing Articles

[Nonoperative treatment for the management of osteonecrosis and bone marrow oedema of the foot and ankle].

Horas K, Eidmann A, Stratos I, Rak D, Rudert M Orthopadie (Heidelb). 2025; .

PMID: 39934504 DOI: 10.1007/s00132-025-04622-x.

Influence of Vitamin D and C on Bone Marrow Edema Syndrome-A Scoping Review of the Literature.

Eidmann A, Eisert M, Rudert M, Stratos I J Clin Med. 2022; 11(22).

PMID: 36431295 PMC: 9696648. DOI: 10.3390/jcm11226820.

Bone marrow oedema syndrome of the foot and ankle in a paediatric population: a retrospective case series with serial MRI evaluation.

De Houwer H, Beek N, Prinsen S, Van Riet A, De Roeck J, Verfaillie S J Child Orthop. 2020; 14(5):440-450.

PMID: 33204352 PMC: 7666800. DOI: 10.1302/1863-2548.14.190189.

References

Schapira D . Transient osteoporosis of the hip. Semin Arthritis Rheum. 1992; 22(2):98-105. DOI: 10.1016/0049-0172(92)90003-v. View

Zhang C, Williams M, Sorensen T, King I, Kestin M, Thompson M . Maternal plasma ascorbic Acid (vitamin C) and risk of gestational diabetes mellitus. Epidemiology. 2004; 15(5):597-604. DOI: 10.1097/01.ede.0000134864.90563.fa. View

Lakhanpal S, Ginsburg W, Luthra H, Hunder G . Transient regional osteoporosis. A study of 56 cases and review of the literature. Ann Intern Med. 1987; 106(3):444-50. DOI: 10.7326/0003-4819-106-3-444. View

Hampl J, Taylor C, Johnston C . Vitamin C deficiency and depletion in the United States: the Third National Health and Nutrition Examination Survey, 1988 to 1994. Am J Public Health. 2004; 94(5):870-5. PMC: 1448351. DOI: 10.2105/ajph.94.5.870. View

Curtiss Jr P, KINCAID W . Transitory demineralization of the hip in pregnancy. A report of three cases. J Bone Joint Surg Am. 1959; 41-A:1327-33. View

Trevisan C, Ortolani S . Bone loss and recovery in regional migratory osteoporosis. Osteoporos Int. 2002; 13(11):901-6. DOI: 10.1007/s001980200124. View

Melhus H, Michaelsson K, Holmberg L, Wolk A, Ljunghall S . Smoking, antioxidant vitamins, and the risk of hip fracture. J Bone Miner Res. 1999; 14(1):129-35. DOI: 10.1359/jbmr.1999.14.1.129. View

Ringe J, Dorst A, Faber H . Effective and rapid treatment of painful localized transient osteoporosis (bone marrow edema) with intravenous ibandronate. Osteoporos Int. 2005; 16(12):2063-8. DOI: 10.1007/s00198-005-2001-6. View

Maggio D, Barabani M, Pierandrei M, Polidori M, Catani M, Mecocci P . Marked decrease in plasma antioxidants in aged osteoporotic women: results of a cross-sectional study. J Clin Endocrinol Metab. 2003; 88(4):1523-7. DOI: 10.1210/jc.2002-021496. View

10.

Falch J, Mowe M, Bohmer T . Low levels of serum ascorbic acid in elderly patients with hip fracture. Scand J Clin Lab Invest. 1998; 58(3):225-8. DOI: 10.1080/00365519850186616. View

11.

McCarthy E . The pathology of transient regional osteoporosis. Iowa Orthop J. 1998; 18:35-42. PMC: 2378158. View

12.

Miyanishi K, Yamamoto T, Nakashima Y, Shuto T, Jingushi S, Noguchi Y . Subchondral changes in transient osteoporosis of the hip. Skeletal Radiol. 2001; 30(5):255-61. DOI: 10.1007/s002560100350. View

13.

Trevisan C, Ortolani S, Monteleone M, Marinoni E . Regional migratory osteoporosis: a pathogenetic hypothesis based on three cases and a review of the literature. Clin Rheumatol. 2002; 21(5):418-25. DOI: 10.1007/s100670200112. View