Transient osteoporosis

Case contributed by Dr Laughlin Dawes

Presentation

This middle-aged female patient presented with hip pain.

Patient Data

Age: Middle age
Gender: Female
Modality: MRI

Coronal short-tau inversion recovery (STIR) MR image shows increased signal (bone oedema) within the left femoral head, neck and proximal metaphysis. There is also a small hip joint effusion.

Case Discussion

A follow-up study at 3 months shows resolution of most of the bone oedema. Transient osteoporosis is a self-limiting disease of unknown aetiology. It occurs in middle-aged males and females in late pregnancy typically. The hip is the most common joint affected. There is rapid-onset hip pain associated with demineralisation, usually unilateral. MRI findings are of diffuse marrow oedema and a small joint effusion. Bone scans show increased uptake. Spontaneous recovery occurs within 2-6 months. The differential diagnosis includes avascular necrosis, metastases, and reflex sympathetic dystrophy. Evidence of subchondral bone collapse, serpiginous subchondral interface, or cold spots on bone scan should prompt a diagnosis of AVN rather than transient osteoporosis.

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Case Information

rID: 35805
Case created: 24th Apr 2015
Last edited: 26th May 2016
Inclusion in quiz mode: Included

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