Transient Osteoporosis of the Knee in Pregnancy

Lloyd, John; Lewis, Mark; Jones, Andrew

doi:10.1055/s-0030-1248091

Cited by 14 publications

(18 citation statements)

References 15 publications

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“…Although considered rare, TOH is a wellestablished complication of the late second to early third trimester of pregnancy [2]. Transient osteoporosis has rarely been reported to affect the knees, but previous documentation of talar involvement has been sparser [3][4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Bilateral transient osteoporosis of the talus in pregnancy

et al. 2009

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We present the case of bilateral transient osteoporosis of the talus in pregnancy, which is rarely reported in the medical literature, confirmed by pre- and postpartum MRI.A gravid 33-year-old white female G4P2A1 with bilateral transient osteoporosis of the talus confirmed by magnetic resonance imaging (MRI) is presented. She was conservatively managed and had clinical resolution several weeks postpartum. A follow-up MRI confirmed improvement in bilateral talus consistent with the natural course of transient osteoporosis.

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Section: Discussionmentioning

confidence: 99%

Bilateral transient osteoporosis of the talus in pregnancy

et al. 2009

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“…The neural mechanisms proposed include reflex sympathetic dystrophy or compression or irritation of obturator or peripheral nerves 87. A positive family history of osteoporosis, thin primiparous women and a reduced calcium intake are some of the other risk factors 11…”

Section: Other Orthopaedic Complications In Pregnancymentioning

confidence: 99%

Musculoskeletal symptoms and orthopaedic complications in pregnancy: pathophysiology, diagnostic approaches and modern management

Bhardwaj

Nagandla

2014

Postgraduate Medical Journal

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Low back pain is a common musculoskeletal symptom in pregnancy that can present as lumbar pain or pelvic girdle pain, with significant physical and psychosocial implications. Pelvic girdle pain is more prevalent and results in greater disability than lumbar pain. It is possible to distinguish between these two conditions from a detailed history based on the site of the pain, its intensity, disability and pain provocation tests. Management of low back pain in pregnancy is conservative, with physical exercise for lumbar pain and minimising activities that exacerbate pain, analgesics and bed rest for pelvic girdle pain, as well as avoiding abduction beyond the pain-free zone in labour. There is evidence that stabilising exercises in patients with pelvic girdle pain postpartum have a beneficial effect. Other treatment modalities that have been shown to be safe and effective include pelvic belts, transcutaneous electrical nerve stimulation, spinal manipulative therapy, acupuncture and complementary therapy with yoga. Other orthopaedic complications in pregnancy such as carpal tunnel syndrome, pubic symphysis rupture, transient osteoporosis and osteonecrosis are usually self-limiting with a satisfactory outcome. However, a lack of awareness and failure to recognise these complications can result in long-term morbidity. Knowledge of the preoperative diagnostic investigations, surgical approaches and intraoperative positioning of the mother to avoid gravid uterus compression is vital in orthopaedic emergencies such as lumbar disc herniation, cauda equina syndrome, fractures and acute compartment syndrome of the lower limb to ensure a safe maternal and fetal outcome and to prevent serious disability. Pregnancy is not contraindicated in women with pre-existing orthopaedic complications such as kyphoscoliosis and total hip arthroplasty as there is no evidence to suggest increased maternal or fetal risks.

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“…A third hypothesis is that pregnancy-associated osteoporosis is secondary to an inherited defect in collagen synthesis, which manifests as an occult form of osteogenesis imperfecta. Possible neural mechanisms include a variant of refl ex sympathetic dystrophy, pathology of the peripheral nerves, compression of the obturator nerve and irritation or compression of the pelvic nerves (Lloyd et al 2006). Suggested vascular mechanisms include ischaemia of the small vessels (Lloyd et al 2006).…”

Section: Aetiologymentioning

confidence: 99%

“…Up to 40% of patients have involvement of other joints. Th e pain may increase with turning movements or weight-bearing and lessen with rest (Lloyd et al 2006). …”

Section: Diagnosismentioning

confidence: 99%

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Pelvic girdle pain during pregnancy and puerperium

Keriakos

Bhatta

Morris³

et al. 2011

Journal of Obstetrics and Gynaecology

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Pelvic girdle pain (PGP) is a term used specifically to pregnancy-related pain in the lumbosacral, sacroiliac and symphysis pubis joints. Pregnancy-induced hormonal and physical changes increase the risk of musculoskeletal problems in pregnancy. The severity of these conditions varies from mild self-limiting pain to a severe disabling condition. PGP is common in pregnancy and while most can be managed as outpatients, a few patients require inpatient admission for further investigations and management. Prompt identification of these conditions is essential to avoid serious disability. Lack of awareness and failure of recognition not only results in women feeling isolated, but may also result in long-term morbidity. In this review, we explore the aetiology, presentation, risk factors, risk of recurrence, differential diagnosis and multidisciplinary management of these conditions. We also enclose obstetric guidelines to increase the awareness of the health professionals.

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Transient Osteoporosis of the Knee in Pregnancy

Cited by 14 publications

References 15 publications

Bilateral transient osteoporosis of the talus in pregnancy

Bilateral transient osteoporosis of the talus in pregnancy

Musculoskeletal symptoms and orthopaedic complications in pregnancy: pathophysiology, diagnostic approaches and modern management

Pelvic girdle pain during pregnancy and puerperium

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