Images in Clinical Rheumatology
Transient Migratory Osteoporosis in Lower Limbs
Osteoporosis transitoria migratoria en miembros inferiores
Antonio Jiménez-Martín
, Rolando Gómez-Cobo, Yolanda Rubio-Gallardo, Santiago Pérez-Hidalgo
Corresponding author
Servicio de Cirugía Ortopédica y Traumatología, Hospital FREMAP Sevilla, Sevilla, Spain
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Rolando Gómez-Cobo, Yolanda Rubio-Gallardo, Santiago Pérez-Hidalgo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Antonio" "apellidos" => "Jiménez-Martín" "email" => array:1 [ 0 => "antonio_jimenez10@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Rolando" "apellidos" => "Gómez-Cobo" ] 2 => array:2 [ "nombre" => "Yolanda" "apellidos" => "Rubio-Gallardo" ] 3 => array:2 [ "nombre" => "Santiago" "apellidos" => "Pérez-Hidalgo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cirugía Ortopédica y Traumatología, Hospital FREMAP Sevilla, Sevilla, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteoporosis transitoria migratoria en miembros inferiores" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 979 "Ancho" => 1500 "Tamanyo" => 133786 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Magnetic resonance: (A) Image at 2nd month. Right knee, involvement of external condyle. (B) Image at 6th month. Right knee, involvement of internal condyle.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Transient osteoporosis is rare and idiopathic.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> It is characterised by arthralgias, radiographic periarticular osteopenia and spontaneous recovery. It was first described in the hip and in women who were in the last three months of their pregnancy.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a> Only 10%–40%<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> of patients affected develop this process in several joints, either simultaneously or successively, in the same limb or even in the contralateral side, which is then called transient migratory osteoporosis.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> The aim of this study is to present a case where the disease migrated to the contralateral knee and to an ankle.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Clinical Case</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 41 year old male with no medical history of interest, presented at the surgery with right knee pain and minimum trauma. Diffuse bone marrow oedema involving the external condyle was reported. Four months later he presented with bone marrow oedema in the ipsilateral internal condyle (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). In other magnetic resonance images we found new bone marrow oedema extension, in the internal femoral condyle of the contraleteral knee and later in the external condyle and pain in the right knee, the NMI of which also showed bone marrow oedema (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>). Treatment with NSAIDS was administered and partial load-bearing but this was ineffective.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Diagnosis</span><p id="par0015" class="elsevierStylePara elsevierViewall">He was diagnosed with transient migratory osteoporosis.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Evolution</span><p id="par0020" class="elsevierStylePara elsevierViewall">Modification of treatment to intramuscular calcitonin for 2 months led to an improvement of the gonalgia, with a drop on the VAS from 9 to 2 points, with 74 points on the Lysholm scale and 73 points on the AOFAS scale. After 12 months of follow-up the areas of bone marrow oedema were smaller in size.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">For Ramberde,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a> this disease appears in the hip (70%, where subchondral fractures may appear in 48.7%, of patients according to Klontzas et al.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a>), knee, ankle and foot, affecting middle aged adults, males (3:1) and pregnant women. It is self-limiting according to Swoopes et al.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> It has been associated with smokers, metabolic problems and overstraining injuries.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> For diagnosis, the following are useful: radiography (osteopenia),bone scintigraphy (homogenous increase in uptake), NMR<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> (oedema, articular effusion, without osteonecrosis), bone density scan (demineralisation) or biopsy (chronic inflammation).</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the differential diagnosis its distinction is interesting, compared with the algodystrophy of Südeck, reflex sympathetic dystrophy or complex regional pain syndrome. This condition is painful after a traumatic event, sometimes with low intensity, and presents with allodynia (or intense pain on response to non painful stimuli), hyperalgesia, and vasomotor disorders with vegetative symptoms. In transient migratory osteoporosis these vegetative symptoms do not arise. Furthermore, the marrow bone oedema presents as an imaging pattern in the NMI characterised by low-intensity signals in T1 and high-intensity signals in STIR T2 in bone marrow. When this oedema appears in several joints without osteonecrosis images, and not in any isolated form, we would diagnose a transient migratory osteoporosis.</p><p id="par0035" class="elsevierStylePara elsevierViewall">However, the algodystrophy of Südeck, reflex sympathetic dystrophy, complex regional pain syndrome, bone marrow oedema syndrome, transient osteoporosis (regional or migratory) and avascular necrosis have similar symptoms, they are idiopathic and present with marrow bone oedema in the NMR. They may therefore form part or be different stages of the same disease, included under the general term of bone marrow oedema syndrome.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">For Emad et al.,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> treatment consists of resting, decompression in the femoral head and drugs such as like calcitonin, pamidronate,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> zoledronate<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> or alendronate.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> Treatment with injectable calcintonin must be limited to short term periods (it was only maintained for 2 months in our case), since current recommendations are for Paget's disease, prevention of acute loss of bone mass due to sudden immobility and hypercalcaemia caused by cancer. Intranasal treatment is not recommended due to the increase in the risk of tumours between 7% and 2.4% compared with placebo.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> We believe its use in transient migratory osteoporosis is only reserved for “report” cases like this one and that if in 4 weeks no response has been obtained, treatment with biphosphonates should be considered.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> When response is favourable, treatment should not be extended beyond 2 months.</p><p id="par0045" class="elsevierStylePara elsevierViewall">To conclude, we could confirm that transient migratory osteoporosis is rare, idiopathic and self-limiting. It evolves with migratory pain on weight-bearing, diffuse periarticular osteopenia and bone marrow oedema in the NRM. Treatment is conservative.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Ethical Responsibilities</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Protection of people and animals</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed comply with the ethical standards of the Committee responsible for human experimentation, the World Medial Association and the Declaration of Helsinki.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Data confidentiality</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have adhered to the protocols of their centre of work on the publication of patient data.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Right to privacy and informed consent</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors have obtained the informed consent of the patients and/or subjects referred to in this article. This document remains in the possession of the corresponding author.</p></span></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinical Case" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Diagnosis" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Evolution" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 5 => array:3 [ "identificador" => "sec0030" "titulo" => "Ethical Responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Right to privacy and informed consent" ] ] ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-12-19" "fechaAceptado" => "2017-02-28" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Jiménez-Martín A, Gómez-Cobo R, Rubio-Gallardo Y, Pérez-Hidalgo S. Osteoporosis transitoria migratoria en miembros inferiores. Reumatol Clin. 2019;15:246–248.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 979 "Ancho" => 1500 "Tamanyo" => 133786 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Magnetic resonance: (A) Image at 2nd month. Right knee, involvement of external condyle. (B) Image at 6th month. Right knee, involvement of internal condyle.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1275 "Ancho" => 800 "Tamanyo" => 76781 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Magnetic resonance at 7th month. Right ankle. Involvement of the astragalus.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 979 "Ancho" => 1500 "Tamanyo" => 138524 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Magnetic resonance imaging: (A) Situation at 10th month. Left knee. Involvement of the internal condyle. (B) Situation at 12th month. Left knee. Involvement of external condyle.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0060" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary bone marrow oedema syndromes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Patel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rheumatology (Oxford)" "fecha" => "2014" "volumen" => "53" "paginaInicial" => "785" "paginaFinal" => "792" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0065" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transient regional osteoporosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Cano-Marquina" 1 => "J.J. Tarín" 2 => "M.Á. García-Pérez" 3 => "A. Cano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.maturitas.2014.01.012" "Revista" => array:6 [ "tituloSerie" => "Maturitas" "fecha" => "2014" "volumen" => "77" "paginaInicial" => "324" "paginaFinal" => "329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24582491" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0070" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoporosis transitoria migratoria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Ramberde" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Cir Ortop Traumatol" "fecha" => "2010" "volumen" => "54" "paginaInicial" => "179" "paginaFinal" => "182" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0075" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Del edema de médula ósea a la osteonecrosis. Nuevos conceptos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. Fernández Cantón" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2008.02.004" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2009" "volumen" => "5" "paginaInicial" => "223" "paginaFinal" => "227" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21794615" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0080" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MR imaging of transient osteoporosis of the hip: an update on 155 hip joints" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "KlontzasME" 1 => "E.E. Vassalou" 2 => "A.H. Zibis" 3 => "A.S. Bintoudi" 4 => "A.H. Karantanas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejrad.2014.11.022" "Revista" => array:6 [ "tituloSerie" => "Eur J Radiol" "fecha" => "2015" "volumen" => "84" "paginaInicial" => "431" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25533717" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0085" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "It is true that regional migratory osteoporosis has a full remission? A follow-up after 14 years. A case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Swoopes" 1 => "N. Mazzini" 2 => "M. Centonze" 3 => "G. Fancellu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Phys Rehabil Med" "fecha" => "2012" "volumen" => "48" "paginaInicial" => "161" "paginaFinal" => "165" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21445027" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0090" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Risk factors in transient osteoporosis: a retrospective study on 23 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Trevisan" 1 => "R. Klumpp" 2 => "R. Compagnoni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10067-016-3228-7" "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "2517" "paginaFinal" => "2522" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26979746" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0095" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transient osteoporosis of the hip, complete resolution after treatment with alendronate as observed by MRI description of eight cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Emad" 1 => "Y. Ragab" 2 => "N. El-Shaarawy" 3 => "J.J. Rasker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10067-012-2060-y" "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "2012" "volumen" => "31" "paginaInicial" => "1641" "paginaFinal" => "1647" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22933125" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0100" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transient migratory osteoporosis: rapid response to pamidronate treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Carty" 1 => "G. Herdman" 2 => "F. Williams" 3 => "U. Srinivasan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RHU.0b013e318064e78d" "Revista" => array:6 [ "tituloSerie" => "J Clin Rheumatol" "fecha" => "2007" "volumen" => "13" "paginaInicial" => "138" "paginaFinal" => "139" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17551379" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0105" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful treatment of transient osteoporosis with intravenous zoledronate: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Maslin" 1 => "M. Karanth" 2 => "S. Bhagat" 3 => "R. Guirguis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1756-185X.12350" "Revista" => array:6 [ "tituloSerie" => "Int J Rheum Dis" "fecha" => "2014" "volumen" => "17" "paginaInicial" => "816" "paginaFinal" => "817" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24673857" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0110" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Oral bisphosphonates in treatment of transient osteoporosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Kibbi" 1 => "Z. Touma" 2 => "N. Khoury" 3 => "T. Arayssi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10067-007-0766-z" "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "2008" "volumen" => "27" "paginaInicial" => "529" "paginaFinal" => "532" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17938988" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001500000004/v1_201906210912/S2173574318301060/v1_201906210912/en/main.assets" "Apartado" => array:4 [ "identificador" => "5795" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Clinical Rheumatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001500000004/v1_201906210912/S2173574318301060/v1_201906210912/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301060?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 98 | 48 | 146 |
| 2024 September | 105 | 56 | 161 |
| 2024 August | 118 | 62 | 180 |
| 2024 July | 124 | 54 | 178 |
| 2024 June | 147 | 59 | 206 |
| 2024 May | 134 | 63 | 197 |
| 2024 April | 145 | 61 | 206 |
| 2024 March | 112 | 44 | 156 |
| 2024 February | 143 | 45 | 188 |
| 2024 January | 115 | 36 | 151 |
| 2023 December | 131 | 30 | 161 |
| 2023 November | 144 | 41 | 185 |
| 2023 October | 160 | 47 | 207 |
| 2023 September | 204 | 42 | 246 |
| 2023 August | 159 | 21 | 180 |
| 2023 July | 139 | 17 | 156 |
| 2023 June | 159 | 28 | 187 |
| 2023 May | 174 | 31 | 205 |
| 2023 April | 96 | 11 | 107 |
| 2023 March | 210 | 29 | 239 |
| 2023 February | 123 | 27 | 150 |
| 2023 January | 141 | 28 | 169 |
| 2022 December | 139 | 32 | 171 |
| 2022 November | 125 | 25 | 150 |
| 2022 October | 155 | 41 | 196 |
| 2022 September | 121 | 35 | 156 |
| 2022 August | 130 | 36 | 166 |
| 2022 July | 85 | 40 | 125 |
| 2022 June | 105 | 41 | 146 |
| 2022 May | 141 | 40 | 181 |
| 2022 April | 139 | 55 | 194 |
| 2022 March | 166 | 49 | 215 |
| 2022 February | 124 | 28 | 152 |
| 2022 January | 140 | 38 | 178 |
| 2021 December | 109 | 53 | 162 |
| 2021 November | 123 | 36 | 159 |
| 2021 October | 154 | 71 | 225 |
| 2021 September | 100 | 50 | 150 |
| 2021 August | 91 | 37 | 128 |
| 2021 July | 97 | 29 | 126 |
| 2021 June | 114 | 40 | 154 |
| 2021 May | 104 | 58 | 162 |
| 2021 April | 244 | 129 | 373 |
| 2021 March | 165 | 33 | 198 |
| 2021 February | 84 | 22 | 106 |
| 2021 January | 58 | 19 | 77 |
| 2020 December | 66 | 19 | 85 |
| 2020 November | 47 | 19 | 66 |
| 2020 October | 41 | 17 | 58 |
| 2020 September | 87 | 22 | 109 |
| 2020 August | 17 | 21 | 38 |
| 2020 July | 28 | 23 | 51 |
| 2020 June | 37 | 17 | 54 |
| 2020 May | 34 | 16 | 50 |
| 2020 April | 48 | 16 | 64 |
| 2020 March | 11 | 4 | 15 |
| 2019 June | 1 | 0 | 1 |
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