Treatment of bone-marrow oedema of the talus with the prostacyclin analogue iloprost. An MRI-controlled investigation of a new method.

Bone marrow oedema syndrome of the talus is a rare cause of pain in the foot, with limited options for treatment. We reviewed six patients who had been treated with five infusions of 50 microg of iloprost given over six hours on five consecutive days. Full weight-bearing was allowed as tolerated. The foot score as described by Mazur et al was used to assess function before and at one, three and six months after treatment. The mean score improved from 58 to 93 points. Plain radiographs were graded according to the Mont score and showed grade-I lesions before and after treatment, indicating that no subchondral fracture or collapse had occurred. MRI showed complete resolution of the oedema within three months. We conclude that the parenteral administration of iloprost may be used in the treatment of this syndrome.