Nontraumatic Osteonecrosis of the Distal Tibia: A Case Presentation and Review of the Literature

J Foot Ankle Surg. 2017 Jan-Feb;56(1):158-166. doi: 10.1053/j.jfas.2016.04.001. Epub 2016 Aug 18.


Osteonecrosis, although commonly occurring in the hip, can also affect the leg and foot. In the foot, it most commonly occurs in the talus. The incidence of osteonecrosis occurring in the tibia is relatively rare. We report a case of a woman who presented to our clinic with ankle pain that was idiopathic in nature. Subsequent magnetic resonance imaging showed findings consistent with osteonecrosis of the bilateral distal tibias and several other lesions located in the shoulder, hip, and calcaneus. The present report also serves as a review of both etiology and treatment of osteonecrosis as it relates to the lower extremity.

Keywords: alcohol; ankle; avascular necrosis; corticosteroids; diaphyseal metaphyseal bone.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Ankle Joint / diagnostic imaging
  • Ankle Joint / physiopathology
  • Ankle Joint / surgery
  • Arthrodesis / methods*
  • Arthroscopy / methods*
  • Bone Substitutes / pharmacology*
  • Debridement / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Osteonecrosis / diagnostic imaging*
  • Osteonecrosis / surgery*
  • Postoperative Care
  • Risk Assessment
  • Severity of Illness Index
  • Surgical Mesh
  • Tibia / diagnostic imaging
  • Tibia / surgery*
  • Time Factors
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome


  • Bone Substitutes