Zoledronic acid is effective in the management of migratory osteoporosis unresponsive to conservative treatment and risedronate: A case report

We describe a case of a 55-year-old woman with migratory osteoporosis (MO) which initially presented as pain with bone marrow edema (BME) evident in magnetic resonance imaging (MRI) of the left ankle and was managed with non-weight-bearing (NWB). The patient was already treated with per os risedronate for postmenopausal osteoporosis. After significant initial improvement, pain and BME relapsed in the left ankle and additionally expanded to insult the foot, while 3 months later the left hip was also affected. Since the combination of NWB, analgesics and risedronate had failed to control the disease, a single infusion of 5mg zoledronic acid (ZA) was administered. One month later the pain in all affected sites was disappeared and BME resolved as shown by MRI performed 3.5 months following ZA infusion. The patient, eventually. returned to her daily routine. This case underlines the effectiveness of ZA in MO and the need for more aggressive treatment in this disease.