Transient osteoporosis of the hip
 Discussion of Transient osteoporosis of the hip
- Transient osteoporosis of the hip typically occurs in middle-aged men or in women in the third trimester of pregnancy.
- There is spontaneous onset of pain, usually progressive over several weeks.
- Patients generally do not have risk factors for avascular necrosis and do not go on to form avascular necrosis.
- Clinical improvement occurs over several weeks to months without specific treatment.
- Some patients later develop similar changes in the opposite hip or in other joints, in which case the term regional migratory osteoporosis may be used.
 Imaging Findings for Transient osteoporosis of the hip
- Plain radiographs may show normal findings early, but within several weeks (usually 4-8), patients develop variable, often profound osteopenia of the femoral head and neck region.
- The joint space is always preserved.
- There is a striking loss of the subchondral cortex of the femoral head, which is virtually pathognomonic for transient osteoporosis.
- Skeletal scintigraphy shows markedly increased homogeneous uptake in the femoral head.
- Scintigraphic findings are positive before osteopenia is seen on radiographs.
- MR imaging in cases of transient osteoporosis shows a diffuse bone marrow edema pattern involving the femoral head, neck, and sometimes intertrochanteric region.
- The signal intensity changes are frequently heterogeneous, particularly on T2- weighted images.
Patient #1: Radiograph, bone scan, and MRI images of a patient with right transient osteoporosis of the hip
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 References for Transient osteoporosis of the hip
- CW Hayes, WF Conway, and WW Daniel. MR imaging of bone marrow edema pattern: transient osteoporosis, transient bone marrow edema syndrome, or osteonecrosis. RadioGraphics 1993 13: 1001-1011.