I have been told by an orthopod that I have regional migratory osteoporosis in my ankle based on an MRI report and should be treated with intravenous bisphosphinates. However my husband, who is a medical physicist says that I cannot have osteoporosis as it is systemic and my Dexa scan last December, done for unrelated reasons, was normal. Who is right?
Although it is less common than common osteoporosis, there have been some reports of regional migratory osteoporosis that have been described in the medical literature. However, intravenous bisphosphonates are not usually given as the first line of treatment -- they are frequently prescribed after other treatments have either failed or not been tolerated. I haven't heard of them being given to someone with a normal DXA scan (the test which is considered the gold standard for diagnosing osteoporosis.) If you and your family have doubts about this physician's recommendation, perhaps you are interested in seeking another opinion from a different specialist before you embark on such a remedy. In the meantime, do take steps to protect your ankle and how much weight you bear on it. Best of luck to you.
Just a quick clarification on my earlier answer -- I mentioned I hadn't ever heard of intravenous bisphosphonates being used on a person with a normal DXA scan -- I should have specified, to treat osteoporosis on a person with a normal DXA scan. Medicines such as Reclast (zoledronic acid) are also used to treat conditions unrelated to osteoporosis (often associated with cancer) and such an individual might have a normal DXA but take the medicine for the other problem. Of course, that's unrelated to your question, but I did want to be as accurate as possible.
I am a doctor and have regional migratory osteoporosis. My bone density is normal - apart from the affected areas. Looking through the literature, there is anecdotal evidence that biphosphonates may help. I have been taking oral treatment in the hope of preventing further attacks, but currently suspect this has not worked (one knee is beginning to stiffen again). I think the problem here is the name of the condition - it is NOT systemic osteoporosis, but a disease of unknown aetiology (possibly neurological which causes focal inflammation with secondary focal areas of reduced bone density.
Hello Hillary,
I was told in 2004 that I suffered of regional transient migratory osteoporosis in both my hips. They discovered this through an MRI, which showed that both hips had stressfractures. Now 2011 I have visted more than 8 hospital's in The Netherlands and had to do various researches. Still today they can't tell exactly what goes wrong and the only thing that they discovered that I have problems with Vitamine D and some other important minerals and vitamines. (I don't know their names in english) I also did througout these years more than 5 dexa scan's which were all oke...so I imagine your questions. Did you have other news in these past 3 years about this disease. All these years I'm searching the internet in the hope to find some answers. When I got these discease I was 35 years old. In most of literature is written that rmo will pass spontanously, but after all these years I'm still having a great deal of pain and now the places which were broken aren't fixed. Í find nothing about complications or other articles about that. I hope you are doing better and I wish you the best!
Kind regards,
Lischa
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