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Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D

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 t...

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Autores principales: Pieropan, Sara, Antoniazzi, Franco, Tadiotto, Elisa, Caldonazzi, Federico, Maschio, Maddalena, Aiello, Giulia, Melotti, Giulia, Cavarzere, Paolo, Piacentini, Giorgio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Bone and Mineral Research 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901693/
https://www.ncbi.nlm.nih.gov/pubmed/31832389
http://dx.doi.org/10.11005/jbm.2019.26.4.241
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author Pieropan, Sara
Antoniazzi, Franco
Tadiotto, Elisa
Caldonazzi, Federico
Maschio, Maddalena
Aiello, Giulia
Melotti, Giulia
Cavarzere, Paolo
Piacentini, Giorgio
author_facet Pieropan, Sara
Antoniazzi, Franco
Tadiotto, Elisa
Caldonazzi, Federico
Maschio, Maddalena
Aiello, Giulia
Melotti, Giulia
Cavarzere, Paolo
Piacentini, Giorgio
author_sort Pieropan, Sara
collection PubMed
description 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.
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spelling pubmed-69016932019-12-12 Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D Pieropan, Sara Antoniazzi, Franco Tadiotto, Elisa Caldonazzi, Federico Maschio, Maddalena Aiello, Giulia Melotti, Giulia Cavarzere, Paolo Piacentini, Giorgio J Bone Metab Original Article 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. The Korean Society for Bone and Mineral Research 2019-11 2019-11-30 /pmc/articles/PMC6901693/ /pubmed/31832389 http://dx.doi.org/10.11005/jbm.2019.26.4.241 Text en Copyright © 2019 The Korean Society for Bone and Mineral Research http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Pieropan, Sara
Antoniazzi, Franco
Tadiotto, Elisa
Caldonazzi, Federico
Maschio, Maddalena
Aiello, Giulia
Melotti, Giulia
Cavarzere, Paolo
Piacentini, Giorgio
Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D
title Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D
title_full Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D
title_fullStr Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D
title_full_unstemmed Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D
title_short Bone Marrow Foot Oedema in Adolescents: The Role of Vitamin D
title_sort bone marrow foot oedema in adolescents: the role of vitamin d
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901693/
https://www.ncbi.nlm.nih.gov/pubmed/31832389
http://dx.doi.org/10.11005/jbm.2019.26.4.241
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