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Case Report Volume 15 Issue 1
Transient migratory osteoporosis: report of a case with sequential multifocal involvement
Frederico Costa, Mafalda Guimarães, Diana Serra, Hugo Couto Amorim
Received: December 05, 2025 | Published: December 22, 2025
Citation: Costa F, Guimarães M, Serra D, et al. Transient migratory osteoporosis: report of a case with sequential multifocal involvement. MOJ Clin Med Case Rep. 2025;15(1):37-40 DOI: 10.15406/mojcr.2025.15.00484
Abstract
Transient migratory osteoporosis (TMO) is a rare condition characterized by sudden, nontraumatic joint pain and bone marrow edema that resolves spontaneously. Its etiology remains unclear, but may involve microtrauma, microcirculatory alterations, and accelerated bone remodeling phenomena. We describe the case of a 57-year-old man, previously healthy, who presented with mechanical right knee pain of three weeks’ duration. Physical examination revealed localized tenderness along the medial joint line, and the initial radiograph was normal. Magnetic resonance imaging (MRI) demonstrated a subchondral insufficiency fracture of the medial femoral condyle, and off-loading with subsequent rehabilitation was initiated. Three months later, the patient developed new onset left knee pain and left forefoot pain. Repeat MRI identified a new insufficiency fracture in the left knee and stress-related bone changes in the forefoot. Bone densitometry showed osteopenia, and laboratory studies were unremarkable. Considering the migratory pattern and imaging findings, a diagnosis of TMO was established. The patient progressed favorably, with complete symptom resolution after six months. TMO is a diagnosis of exclusion that should be considered in middle-aged adults presenting with acute joint pain after a thorough physical examination and structured clinical assessment. Prognosis is generally good, with only temporary loss of bone mineral density. Medical follow-up and rehabilitation treatment are essential for maintaining patient functionality. This case also highlights the importance of distinguishing transient migratory osteoporosis from osteonecrosis, which may present with similar early symptoms but requires a different therapeutic approach.
Keywords: transient migratory osteoporosis, bone marrow edema syndrome, insufficiency fracture, magnetic resonance imaging, osteopenia
©2025 Costa, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.