Case Reports: Transient Osteoporosis of the Hip: An Atypical Case (original) (raw)
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Transient osteoporosis of the hip during pregnancy. A case report
PubMed, 1991
Transient hip osteoporosis is a benign, process mainly affecting men. A 31-year-old woman in the 31st week of pregnancy was diagnosed as having the disorder. Impairment of venous flow associated with pregnancy might have been the cause of the osteoporosis and superficial thrombophlebitis.
Postpartum Transient Osteoporosis of Hip (TOH) of a 31 year old woman: a case Report
Hip pain, pelvic pain and low back pain (LBP) are common conditions during pregnancy and postpartum. Certain numbers of cases of transient osteoporosis of hip (TOH) have been reported in the literature, but its real prevalence seems to be underestimated. We report a case of 31-year-old patient who presented during postpartum period (two weeks after delivery) with severe right hip joint pain and radicular symptoms which mimics lumbar radiculopathy. On request of an Magnetic Resonance Imaging (MRI) scan of lumbar-sacral spine, short tau/TI inversion recovery (STIR) coronal sequence was also performed which ultimately led to the identification of features of TOH. The use of coronal STIR sequence in addition to the routine sequences of lumbar-sacral imaging was paramount of importance in diagnosing the condition.Patient was treated conservatively, with partial resolution of symptoms.
Bilateral Hip Fractures Associated with Transient Osteoporosis of Pregnancy
Journal of the Royal Army Medical Corps, 2011
A case of transient osteoporosis of pregnancy complicated by bilateral neck of femur fractures is reported. We discuss the condition and review the literature, provide information to aid in the diagnostic dilemma clinicians may face when considering imaging techniques and the potential for foetal harm during radiation exposure. We discuss management strategies in such patients. CASE REPORT Figure 1: AP radiograph of the pelvis demonstrating bilateral femoral neck fractures. Figure 2: Postoperative AP radiograph of the pelvis following fixation of the fractures with cannulated hip screws.
BMJ Case Reports, 2021
Transient osteoporosis of the hip (TOH) is a rare cause of pelvic pain in the third trimester of pregnancy and post partum. Although several cases have been reported in literature, its aetiology is poorly understood. The diagnosis is commonly missed in pregnancy, as the presenting symptoms can be vague, and the risks of radiographic imaging deter clinicians from pursuing investigation. In extreme cases, this pathology presents with neck of femur fractures, with no current guidelines on optimal management. We describe the case of a 24-year-old woman who presented with bilateral neck of femur fractures at 34 weeks gestation. Following an emergency caesarean section, operative management consisted of bilateral closed reduction and internal fixation using dynamic hip screws. Postoperative radiographs demonstrated failure of fixation on the left side, which was revised to a complex primary arthroplasty. This case demonstrates both the diagnostic and management challenges associated with ...
A Not So Transient “Transient Osteoporosis” of the Spine in Pregnancy
Clinical Case Reports: Open Access, 2021
Transient Osteoporosis of Pregnancy was first described in 1958 by Curtiss and Kincaid after evaluation of three pregnant patients with painful hips during their third trimester [1]. It is a rare potential complication of pregnancy which unexpectedly affects young, healthy women with a previously uneventful pregnancy [2]. The most commonly affected area is the femoral neck, but it can also involve the shoulder, knee, and ankle [3]. The diagnosis is one of exclusion with the commonest differential diagnoses being a joint infection, rheumatoid arthritis, avascular necrosis of femoral head, pigmented villonodular synovitis,
European Journal of Orthopaedic Surgery & Traumatology, 2003
Transient osteoporosis of the hip is an uncommon condition that affects young and middleaged men, and women during the third trimester of pregnancy. Its incidence and aetiology in pregnancy is unknown. It is bilateral in approximately one third of patients. The patient characteristically gives a history of gradual onset of groin pain increasing in severity over a number of weeks, with pain worse on weight bearing. There is no history of trauma or systemic upset. Differential diagnoses are avascular necrosis of the hip, neoplasm, osteomyelitis and synovitis. Clinical diagnosis can be elusive, and symptoms are often misinterpreted leading to unnecessary tests and morbidity. Diagnosis is by radiological investigation. Treatment is conservative, including protected weight bearing, physical therapy and non-steroidal analgesics. We present a highly unusual case of sequential bilateral transient osteoporosis of the hip in a non-pregnant woman. Initial presentation mimicked septic arthritis leading to arthrotomy.
Pregnancy-associated transient osteoporosis of the hip: results of a case-control study
Archives of Osteoporosis, 2017
The etiology and underlying mechanisms of transient of osteoporosis of the hip (TOH) during pregnancy are still unclear, since no systematic analyses exist. Our results support the hypothesis that TOH is a multifactorial disease, which is associated with immobility, dental problems, and lack of exercise in childhood. Introduction Pregnancy-associated transient osteoporosis of the hip (TOH) is a rare but severe form of osteoporosis, which may affect a subgroup of women in the last trimester of pregnancy or immediately postpartum. Common symptoms include acute pain of the hip(s) due to bone marrow edema or even hip fractures. The exact underlining mechanisms of this disorder are still unknown since no published systematic analyses exist. Methods Out of a total of 52 TOH patients, 33 TOH patients could be matched with 33 healthy controls according to age, region, and gravity. The aim of this retrospective case-control study was to evaluate the risk factors for TOH in a homogenous population of women. Results The baseline characteristics of the two study groups were similar. Overall, 12.1% of the TOH patients sustained a hip fracture. Expectedly, 90.9% of the TOH patients complained about pain of the hip (p ≤ 0.001). TOH patients suffered more frequently from severe dental problems during childhood (p = 0.023) and performed less often sports before and after puberty (p ≤ 0.001), whereas the frequency of immobilization during pregnancy was threefold higher compared to the control group (p = 0.007). We found a significant increase of the TOH risk in patients with dental problems in childhood (OR 3.7; CI 1.3-10.7) as well as in patients with lack of exercise during childhood (OR 4.2; CI 1.3-12.9). Conclusions Our results support the hypothesis that pregnancy-associated TOH is a multifactorial disease, to which several individual factors may contribute. Hereby, we found significant associations with immobility, dental problems, and lack of exercise in childhood.