- See:
Musculoskeletal Considerations in Pregancy:
- Discussion:
- uncommon disease which is a diagnosis of exclusion;
- most often seen in women during the third trimester of pregnancy and in middle-aged men;
- typically there is no antecendent trauma;
- upto 40% of patients may show involvement in other joints;
- Clinical Findings:
- groin pain, and mild limited ROM of hip;
- patients may be unable to bear weight even if hip pain is minimal;
-
ESR may be elevated;
- Radiographs:
- radiographic findings may lag behind clinical symptoms by 1-2 months;
- osteopenia diffusely involves femoral head and neck;
- may be confused w/
AVN or
femoral neck stress frx;
- joint space is preserved;
- Bone Scan:
- sensitive but not specific;
-
technetium 99m may show increased uptake before x-ray changes appear;
- scan will show increased diffuse uptake of the whole femoral head w/
tapering over femoral neck and increased uptake in acetabulum;
- scan usually returns to normal 12-15 months after onset of symptoms;
- bone scan may also show increased uptake in other osteopenic joints;
- MRI:
- decreased signal intensity of bone marrow on
T1-images;
- increased signal intensity relative to the intensity of normal marrow on
T2-images;
- joint effusions are characteristically seen on T2-images;
- Clinical Course:
- spontaneous recovery usually occurs within 2-9 months after treatment w/ joint protection, limited wt bearing, & analgesics;
- in pregnancy, symptoms tend to resolve in the first few postpartum months;
-
stress fracture can occur in the inadequately protected hip;
Transient osteoporosis of the hip in pregnancy. Review of the literature and a case report.
Beaulieu, J. G.
Clin. Orthop., 115: 165-168, 1976.
Transient osteoporosis of the hip: MR imaging. Bloem, J. L.
Radiology, 167: 753-755, 1988.
Transient osteoporosis. Bramlett, K. W. Clin. Orthop., 222: 197-202, 1987.
Transient osteoporosis of the hip of pregnancy. Two cases complicated by pathological fracture.
Brodell, J. D.
J. Bone and Joint Surg., 71-A: 1252-1257, Sept. 1989.
Transient painful osteoporosis of the hip in pregnancy. Lose, G., and Lindholm, P.
Internat. J. Gynaec. and Obstet., 24: 13-16, 1986.
Transient osteoporosis of the hip. Magnetic resonance imaging. Takatori, Y. Clin. Orthop., 271: 190-194, 1991.
Transient marrow edema syndrome of the hip: results after core decompression. A prospective MRI-controlled study in 22 patients.
Changes in bone mineral density in transient osteoporosis of the hip.
