Transient osteoporosis of the hip

Case contributed by Dr Ian Bickle

Presentation

Middle aged male patient with persistent pain in the right hip and thigh. No history of trauma.

Patient Data

Age: 44
Gender: Male

High T2/STIR and low T1 signal in the right femoral head and neck.  No enhancement.

No cortical irregularity of collapse.  No joint effusion.

MRI

Follow up study 4 months later

The right hip on the follow up study is completely normal.

The high T2 signal has completely resolved.

Case Discussion

Idiopathic transient osteoporosis of the hip (ITOH) is a self limiting entity of unknown cause, although thought to have a vascular basis and possible overactivity of the sympathetic system.

Traditionally taught as being a condition of pregnant women, it is in reality more common in middle aged men, as in this case.

Striking high signal in demonstrated in the TIRM sequences, especially when compared to the normal left side on the coronal sequences.  Its appearances are different to those of AVN.

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Case information

rID: 34587
Case created: 27th Feb 2015
Last edited: 11th Jul 2016
Inclusion in quiz mode: Included

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