title: Nontraumatic Osteonecrosis of the Distal Tibia: A Case Presentation and Review of the Literature.
abstract: 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.
authors.affiliation: Foot and Ankle Surgeon, Longview Orthopedic Associates, Longview, WA.
authors.forename: Jacob M
authors.initials: JM
authors.lastname: McLeod
authors.affiliation: Attending Surgeon, Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO.
authors.forename: Alan
authors.initials: A
authors.lastname: Ng
authors.affiliation: Director of Research, Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO.
authors.forename: Dustin L
authors.initials: DL
authors.lastname: Kruse
authors.affiliation: Program Director, Highlands-Presbyterian/St. Luke's Podiatric Medicine and Surgery Residency Program, Denver, CO. Electronic address: pstonehighlandspslresidency@comcast.net.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stone
mesh_terms: D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D001174:Arthrodesis / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D018786:Bone Substitutes / Q000494:pharmacology*; D003646:Debridement / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D010020:Osteonecrosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D011182:Postoperative Care; D018570:Risk Assessment; D012720:Severity of Illness Index; D013526:Surgical Mesh; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes
keywords: alcohol; ankle; avascular necrosis; corticosteroids; diaphyseal metaphyseal bone