Management of transient bone osteoporosis: a systematic review

Br Med Bull. 2023 Sep 12;147(1):79-89. doi: 10.1093/bmb/ldad012.

Abstract

Introduction: Transient bone osteoporosis (TBO) is characterized by persistent pain, loss of function, no history of trauma and magnetic resonance image (MRI) findings of bone marrow edema.

Source of data: PubMed, Google scholar, EMABSE and Web of Science were accessed in February 2023. No time constrains were used for the search.

Areas of agreement: TBO is rare and misunderstood, typically affecting women during the third trimester of pregnancy or middle-aged men, leading to functional disability for 4-8 weeks followed by self-resolution of the symptoms.

Areas of controversy: Given the limited evidence in the current literature, consensus on optimal management is lacking.

Growing points: This systematic review investigates current management of TBO.

Areas timely for developing research: A conservative approach leads to the resolution of symptoms and MRI findings at midterm follow-up. Administration of bisphosphonates might alleviate pain and accelerate both clinical and imaging recovery.

Keywords: bisphosphonates; osteoporosis; syndrome; transient.

Publication types

  • Systematic Review

MeSH terms

  • Bone Marrow Diseases* / diagnosis
  • Diphosphonates / therapeutic use
  • Edema / diagnosis
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Osteoporosis* / diagnostic imaging
  • Osteoporosis* / drug therapy
  • Pregnancy

Substances

  • Diphosphonates