Subscribe to RSS
DOI: 10.1055/s-0043-1771004
Talus Osteonecrosis after Chemotherapy: A Case Report
Article in several languages: português | English Financial Support The authors declare that there was no financial support from public, commercial, or non-profit sources.
Abstract
This paper described a case of talus osteonecrosis in a 13-year-old female with a diagnosis of T-type acute lymphocytic leukemia, who underwent chemotherapy and treatment with glucocorticoids, attended at the Orthopedics and Traumatology Sector of our institution. After approximately six months of treatment, the patient began to complain of sporadic pain in her left ankle with progressive worsening. Bone scintigraphy and magnetic resonance imaging of the ankles showed the presence of avascular osteonecrosis of the bilateral talar body. We opted for non-surgical treatment with analgesia and anti-inflammatory drugs, in addition to removal of the load associated with the use of immobilization of the extramedullary tutor for four weeks, followed by physical therapy rehabilitation with analgesia and progressive increase in load.
Work carried out at the Orthopedics and Traumatology Service, Samuel Libânio Clinical Hospital, Pouso Alegre, MG, Brazil.
Publication History
Received: 02 June 2022
Accepted: 27 October 2022
Article published online:
22 April 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
Referências
- 1 Chang C, Greenspan A, Gershwin ME. The pathogenesis, diagnosis and clinical manifestations of steroid-induced osteonecrosis. J Autoimmun 2020; 110: 102460
- 2 Moon DK. Epidemiology, Cause, and Anatomy of Osteonecrosis of the Foot and Ankle. Foot Ankle Clin 2019; 24 (01) 1-16
- 3 Jones DN. Multifocal osteonecrosis following chemotherapy and short-term corticosteroid therapy in a patient with small-cell bronchogenic carcinoma. J Nucl Med 1994; 35 (08) 1347-1350
- 4 Bayram S, Şahin K, Polat G. Osteonecrosis of the talus of a child with acute lymphoblastic leukemia: A case report. Foot 2020; 42: 101649
- 5 Krull K, Kunstreich M, Bronsema A. et al. Osteonecrosis in children with acute lymphoblastic leukemia at initial diagnosis and prior to any chemotherapy. Leuk Lymphoma 2019; 60 (01) 78-84
- 6 Kunstreich M, Kummer S, Laws HJ, Borkhardt A, Kuhlen M. Osteonecrosis in children with acute lymphoblastic leukemia. Haematologica 2016; 101 (11) 1295-1305
- 7 Hyakuna N, Shimomura Y, Watanabe A. et al; Japanese Childhood Cancer and Leukemia Study Group (JCCLSG). Assessment of corticosteroid-induced osteonecrosis in children undergoing chemotherapy for acute lymphoblastic leukemia: a report from the Japanese Childhood Cancer and Leukemia Study Group. J Pediatr Hematol Oncol 2014; 36 (01) 22-29
- 8 Jäger M, Zilkens C, Westhoff B, Jelinek EM, Kozina G, Krauspe R. Efficiency of iloprost treatment for chemotherapy-associated osteonecrosis after childhood cancer. Anticancer Res 2009; 29 (08) 3433-3440
- 9 Padhye B, Dalla-Pozza L, Little DG, Munns CF. Use of zoledronic acid for treatment of chemotherapy related osteonecrosis in children and adolescents: a retrospective analysis. Pediatr Blood Cancer 2013; 60 (09) 1539-1545
- 10 Janke LJ, Kim J, Payton MA. et al. Effects of zoledronic acid on osteonecrosis and acute lymphoblastic leukemia treatment efficacy in preclinical models. Pediatr Blood Cancer 2021; 68 (10) e29183