Bilateral transient osteoporosis of the hip: a neglected cause of hip pain during pregnancy.

IF 1.4 4区 医学 Q3 RHEUMATOLOGY
ARP Rheumatology Pub Date : 2024-04-01
Catarina Dantas Soares, Diogo Roriz, Maria Pontes-Ferreira, Anita Cunha, Susana Almeida, Soraia Azevedo, Daniela Santos-Faria
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Abstract

Transient osteoporosis of the hip (TOH) is an important but often neglected cause of hip pain, which can gradually lead to debilitating mobility and carries risks such as fracture or avascular necrosis. A 39-year-old woman presented to the Rheumatology department two weeks post-cesarean delivery, reporting the onset of left mechanical hip pain since the 33rd week of pregnancy. After delivery, similar complaints emerged on the right side. Hip X-ray showed a decrease in bone density in the left hip. Later, Magnetic Resonance Imaging revealed bilateral bone marrow edema in both proximal femurs. The diagnosis of TOH was established, and the patient was treated with conservative measures. Seven months later, she was asymptomatic. Pregnancy is a recognized risk factor for TOH, especially in the last trimester. It is an important differential diagnosis to consider in cases of hip pain in pregnant or newly breastfeeding women.

双侧髋部一过性骨质疏松症:孕期髋部疼痛的一个被忽视的原因。
一过性髋关节骨质疏松症(TOH)是导致髋关节疼痛的一个重要原因,但却常常被忽视,它会逐渐导致行动不便,并带来骨折或血管性坏死等风险。一名 39 岁的妇女在剖腹产两周后到风湿病科就诊,称自怀孕第 33 周开始出现左侧机械性髋关节疼痛。分娩后,右侧也出现了类似症状。髋部 X 光片显示左侧髋部骨密度下降。随后,磁共振成像显示双侧股骨近端骨髓水肿。TOH诊断成立,患者接受了保守治疗。七个月后,她已无任何症状。妊娠是TOH的公认危险因素,尤其是在妊娠的最后三个月。在孕妇或哺乳期妇女出现髋关节疼痛时,这是一个需要考虑的重要鉴别诊断。
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CiteScore
1.20
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