Short-Term Teriparatide for Bone Marrow Edema Secondary to Complex Regional Pain Syndrome: Case Reports on Efficacy After Two Years of Follow-Up

Felice Galluccio; Abdallah El Sayed Allam; Francesco Perdisa; Ke-Vin Chang

doi:10.7759/cureus.8119

Short-Term Teriparatide for Bone Marrow Edema Secondary to Complex Regional Pain Syndrome: Case Reports on Efficacy After Two Years of Follow-Up

Cureus. 2020 May 14;12(5):e8119. doi: 10.7759/cureus.8119.

Authors

Felice Galluccio¹, Abdallah El Sayed Allam², Francesco Perdisa³, Ke-Vin Chang⁴

Affiliations

¹ Rheumatology - Experimental and Clinical Medicine, University of Florence, Florence, ITA.
² Physical Medicine, Rheumatology and Rehabilitation, Tanta University Hospitals & Faculty of Medicine, Tanta University, Tanta, EGY.
³ Hip and Knee Replacement, IRCCS Istituto Ortopedico Rizzoli, Bologna, ITA.
⁴ Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, TWN.

Abstract

Bone marrow edema secondary to chronic pain syndrome after knee trauma is a disabling condition that presents with localized pain, allodynia, edema, decreased range of motion and osteopenia. The management includes a variety of medications and rehabilitation. The treatment of refractory diseases is challenging for most physicians. We present two cases of refractory bone edema secondary to complex regional pain syndrome that were successfully treated with a short-term regimen of teriparatide (TPT), a biosynthetic analogue (PTH 1-34) of the human parathormone. The rapid and sustained pain reduction with recovery of knee function for two years following administration of TPT demonstrated its potential for the treatment of bone edema due to complex regional pain syndrome.

Keywords: bone marrow edema; complex regional pain syndrome; knee injury; teriparatide.

Publication types

Case Reports