Transitory Osteoporosis of the Hip - Case Report
Transitory osteoporosis of the hip (TOH) is a very infrequent pathology that affects the proximal end of the femur. It occurs in middle-aged patients and is also described during pregnancy, usually in the third trimester. It is a process of unknown (idiopathic) etiology, of benign and self-limited e...
Guardado en:
| Autores principales: | , , , , |
|---|---|
| Formato: | Artículo revista |
| Lenguaje: | Español |
| Publicado: |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2019
|
| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/25651 |
| Aporte de: |
| id |
I10-R327-article-25651 |
|---|---|
| record_format |
ojs |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-327 |
| container_title_str |
Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
transitory osteoporosis hip magnetic resonance imaging osteoporosis transitoria cadera resonancia nuclear magnética |
| spellingShingle |
transitory osteoporosis hip magnetic resonance imaging osteoporosis transitoria cadera resonancia nuclear magnética Quinteros , Carlos Mauricio Calantoni, Miguel Simondi , Néstor Gabriel Zeballos, Luis Sanchez Carpio , Diego Transitory Osteoporosis of the Hip - Case Report |
| topic_facet |
transitory osteoporosis hip magnetic resonance imaging osteoporosis transitoria cadera resonancia nuclear magnética |
| author |
Quinteros , Carlos Mauricio Calantoni, Miguel Simondi , Néstor Gabriel Zeballos, Luis Sanchez Carpio , Diego |
| author_facet |
Quinteros , Carlos Mauricio Calantoni, Miguel Simondi , Néstor Gabriel Zeballos, Luis Sanchez Carpio , Diego |
| author_sort |
Quinteros , Carlos Mauricio |
| title |
Transitory Osteoporosis of the Hip - Case Report |
| title_short |
Transitory Osteoporosis of the Hip - Case Report |
| title_full |
Transitory Osteoporosis of the Hip - Case Report |
| title_fullStr |
Transitory Osteoporosis of the Hip - Case Report |
| title_full_unstemmed |
Transitory Osteoporosis of the Hip - Case Report |
| title_sort |
transitory osteoporosis of the hip - case report |
| description |
Transitory osteoporosis of the hip (TOH) is a very infrequent pathology that affects the proximal end of the femur. It occurs in middle-aged patients and is also described during pregnancy, usually in the third trimester. It is a process of unknown (idiopathic) etiology, of benign and self-limited evolution. Its diagnosis is imaging and must be distinguished particularly from an initial stage of avascular bone necrosis (ABN), whose prognosis and treatment differs substantially. In addition, we should keep in mind, among the differential diagnoses to infectious diseases (septic arthritis), tumor and idiopathic condrolysis.
Case presentation: 33 year old male patient, no medical history. He consulted referring pain in the left inguinal region for a month and a half of evolution, without triggering trauma. He had conducted prior consultations, which included normal radiological studies; indicating restriction of activities and anti-inflammatory analgesics. In the history he reported that he practiced martial arts in a recreational way and that the pain began suddenly, of moderate and persistent intensity, intensifying with gait or climbing stairs; decreasing with seating and recumbency. On physical examination, he located the pain at the intra-articular level in the left hip, increased with internal rotation and flexion, without achieving complete mobility by voluntary defense. Radiographs of the pelvis (forehead) and both hips (forehead and axial) showed no abnormalities. Magnetic resonance imaging (MRI) demonstrated the presence of a medullary bone edema in the left proximal femoral epiphysis, compatible with TOH. Hematological studies, including bone markers were normal. Conservative treatment with discharge (crutches), calcium, vitamin D, bisphosphonates and analgesics was indicated. After a favorable clinical and imaging evolution (control with Rx and MRI), at eight weeks he returned to his usual activities.
It is unlikely to differentiate clinically this pathology from other processes that compromise the hip joint. Despite being an infrequent entity with a good prognosis, its differential diagnosis must be taken into account, especially in the middle ages of life and pregnant patients. It is important for early diagnosis the use of MRI when circumstances allow. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2019 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/25651 |
| work_keys_str_mv |
AT quinteroscarlosmauricio transitoryosteoporosisofthehipcasereport AT calantonimiguel transitoryosteoporosisofthehipcasereport AT simondinestorgabriel transitoryosteoporosisofthehipcasereport AT zeballosluis transitoryosteoporosisofthehipcasereport AT sanchezcarpiodiego transitoryosteoporosisofthehipcasereport AT quinteroscarlosmauricio osteoporosistransitoriadecaderareportedecaso AT calantonimiguel osteoporosistransitoriadecaderareportedecaso AT simondinestorgabriel osteoporosistransitoriadecaderareportedecaso AT zeballosluis osteoporosistransitoriadecaderareportedecaso AT sanchezcarpiodiego osteoporosistransitoriadecaderareportedecaso |
| first_indexed |
2024-09-03T21:00:50Z |
| last_indexed |
2024-09-03T21:00:50Z |
| _version_ |
1809210147596140544 |
| spelling |
I10-R327-article-256512024-08-27T18:26:01Z Transitory Osteoporosis of the Hip - Case Report Osteoporosis transitoria de cadera - reporte de caso Quinteros , Carlos Mauricio Calantoni, Miguel Simondi , Néstor Gabriel Zeballos, Luis Sanchez Carpio , Diego transitory osteoporosis hip magnetic resonance imaging osteoporosis transitoria cadera resonancia nuclear magnética Transitory osteoporosis of the hip (TOH) is a very infrequent pathology that affects the proximal end of the femur. It occurs in middle-aged patients and is also described during pregnancy, usually in the third trimester. It is a process of unknown (idiopathic) etiology, of benign and self-limited evolution. Its diagnosis is imaging and must be distinguished particularly from an initial stage of avascular bone necrosis (ABN), whose prognosis and treatment differs substantially. In addition, we should keep in mind, among the differential diagnoses to infectious diseases (septic arthritis), tumor and idiopathic condrolysis. Case presentation: 33 year old male patient, no medical history. He consulted referring pain in the left inguinal region for a month and a half of evolution, without triggering trauma. He had conducted prior consultations, which included normal radiological studies; indicating restriction of activities and anti-inflammatory analgesics. In the history he reported that he practiced martial arts in a recreational way and that the pain began suddenly, of moderate and persistent intensity, intensifying with gait or climbing stairs; decreasing with seating and recumbency. On physical examination, he located the pain at the intra-articular level in the left hip, increased with internal rotation and flexion, without achieving complete mobility by voluntary defense. Radiographs of the pelvis (forehead) and both hips (forehead and axial) showed no abnormalities. Magnetic resonance imaging (MRI) demonstrated the presence of a medullary bone edema in the left proximal femoral epiphysis, compatible with TOH. Hematological studies, including bone markers were normal. Conservative treatment with discharge (crutches), calcium, vitamin D, bisphosphonates and analgesics was indicated. After a favorable clinical and imaging evolution (control with Rx and MRI), at eight weeks he returned to his usual activities. It is unlikely to differentiate clinically this pathology from other processes that compromise the hip joint. Despite being an infrequent entity with a good prognosis, its differential diagnosis must be taken into account, especially in the middle ages of life and pregnant patients. It is important for early diagnosis the use of MRI when circumstances allow. La osteoporosis transitoria de cadera (OTC), es una patología muy infrecuente que afecta al extremo proximal de fémur. Se presenta en pacientes de mediana edad y está descripta también durante el embarazo, generalmente en el tercer trimestre. Se trata de un proceso de etiología desconocida (idiopático), de evolución benigna y autolimitado. Su diagnóstico es imagenológico y hay que diferenciarlo particularmente de un estadio inicial de necrosis ósea avascular (NOA), cuyo pronóstico y tratamiento difiere sustancialmente. Además, deberíamos tener presente, entre los diagnósticos diferenciales a las patologías infecciosas (artritis sépticas), tumorales y condrolisis idiopática. Presentación del caso: Paciente masculino de 33 años de edad, sin antecedentes médicos. Consultó refiriendo dolor en región inguinal izquierda de un mes y medio de evolución, sin un trauma desencadenante. Había realizado consultas previas, que incluían estudios radiológicos normales; indicándole restricción de actividades y analgésicos antiinflamatorios. En la anamnesis relató que practicaba artes marciales de forma recreativa y que el dolor comenzó en forma súbita, de intensidad moderada y persistente, intensificándose con la marcha o subiendo escaleras; disminuyendo con la sedestación y el decúbito. Al examen físico, localizaba el dolor a nivel intraarticular en cadera izquierda, aumentaba con la rotación interna y la flexión, sin lograr movilidad completa por defensa voluntaria. Las radiografías de pelvis (frente) y ambas caderas (frente y axiales), no mostraban alteraciones. La resonancia nuclear magnética (RNM), demostró la presencia de un edema óseo medular en epífisis femoral proximal izquierda, compatible con OTC. Los estudios hematológicos, incluyendo marcadores óseos fueron normales. Se indicó tratamiento conservador con descarga (muletas), calcio, vitamina D, bifosfonatos y analgésicos. Tras una evolución clínica e imagenológica favorable (control con Rx y RNM), a las ocho semanas retornó a sus actividades habituales. Es improbable diferenciar clínicamente esta patología de otros procesos que comprometen la articulación de la cadera. A pesar de tratarse de una entidad infrecuente y de buen pronóstico, debe tenerse en cuenta su diagnóstico diferencial, especialmente en edades medias de la vida y pacientes embarazadas. Es importante para su diagnóstico temprano la utilización de RNM cuando las circunstancias lo permitan. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019-10-09 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://revistas.unc.edu.ar/index.php/med/article/view/25651 Revista de la Facultad de Ciencias Médicas de Córdoba.; 2019: Suplemento JIC XX Revista de la Facultad de Ciencias Médicas de Córdoba; 2019: Suplemento JIC XX Revista da Faculdade de Ciências Médicas de Córdoba; 2019: Suplemento JIC XX 1853-0605 0014-6722 10.31053/1853.0605.v76.nSuplemento spa https://revistas.unc.edu.ar/index.php/med/article/view/25651/27370 Derechos de autor 2019 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |