Migratory Osteolysis of the Lower Extremities

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Abstract
A syndrome characterized by regional and migratory osteoporosis in the lower extremities occurred in 3 patients, either spontaneously or after mild trauma. Initially there was pain and tenderness in the general region of the knee, ankle or foot, associated with a rapid progression of a spotty demineral-ization in the bones of the affected area. The pain was aggravated by weight bearing. There was edema, warmth and evidence of increased vascularity of the overlying soft tissue. The clinical findings subsided in 6-9 mo. accompanied by improved mineralization of the involved bones. In all subjects, identical and sequential episodes of pain and spotty osteoporosis occurred over a period of 2 yrs in other areas of the same or opposite lower extremity without initiating cause. The same area was never involved a 2nd time within a year of onset. Various forms of arthritis and general metabolic bone disease could readily be ruled out. The syndrome resembles Sudek''s atrophy (reflex osteodystrophy) but is unique in that there is subsequent migratory and regional osteoporosis and soft tissue swelling of other areas in the same or opposite lower extremity.

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