Diagnosis and conservative treatment of transient osteoporosis of the hip
10.3760/cma.j.issn.0253-2352.2010.10.007
- VernacularTitle:髋部暂时性骨质疏松症的诊断与保守治疗
- Author:
Daming SUN
;
Hong ZHANG
- Publication Type:Journal Article
- Keywords:
Osteoporosis;
Bone marrow;
Edema;
Hip joint
- From:
Chinese Journal of Orthopaedics
2010;30(10):951-954
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate clinical diagnosis and clinical outcome of conservative treatment for transient osteoporosis of the hip. Methods Between October 2006 and July 2009, 10 patients with transient osteoporosis of the hip were treated in out-patient clinic. The clinical and radiologic characteristics were studied retrospectively. There were 4 males and 6 females with an average age of 35 years (range, 22-43). All female patients were not in the period of pregnancy. The diagnosis was made based upon detailed X-ray and MRI evaluations. X-ray revealed osseous demineralization of the femoral head at 8 patients and showed normal at 2 patients. All patients showed the characteristic MRI pattern of transient osteoporosis of the hip. The involved hip had a diffuse and homogeneous area of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images in the head, neck and the intertrochanteric region in 7 patients. Non-operative management, consisting of symptomatic therapy and reduction of weight bearing was performed in all patients. Symptomatic therapy included nonsteroidal anti-inflammatory drug and bisphosphonate administration. Verbal pain rating scale and Harris hip score were used to assess the results of the treatment. Results All 10 patients have been followed up at 3, 6 and 12 months interval after they received treatments. The last follow-up duration of all 10 patients was 2.5 years (range, 1.0-3.5). All patients had pain relief in varying degrees at 1 day after the therapy. The pain scale level had diminished in all patients, while the Harris hip score had increased from 74.5 pre-therapy to 96 post-therapy. X-ray and MRI showed complete recovery after 6 months. No complications were found among them. Conclusion Transient osteoporosis of the hip was considered to be a distinct, self-limiting, and transient disease, which had specific clinical and radiologic characters. Non-operative management should be the first choice to treat this disease.
