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Rare Case of Osteoporosis in Both Hips of a Pregnant Woman
Doctors in Australia present a case report of a 37-year old woman with osteoporosis. Osteoporosis is a decreased bone mineral density. It can lead to thinning of the bones and fracture. This patient was 32 weeks into her second pregnancy. Pain started in both hips, then knees, then ankles. There was no history of trauma, accident, or illness.
After six weeks using crutches and anti-inflammatory drugs, the pain was so bad that she ended up in a wheelchair and had a cesarean section to deliver the baby. Her symptoms got better after the baby was born but it was a full year before she was back to normal.
There's no way to tell what caused this rare case of osteoporosis. The most obvious risk factor was pregnancy. But bone loss is usually linked with decreased estrogen after menopause not increased during pregnancy.
Diagnosis and treatment of osteoporosis in pregnant women can be difficult. Lab work doesn't show much and X-rays aren't advised. MRI is possible but the woman in this study had claustrophobia. Bone scans after pregnancy confirmed the diagnosis.
When osteoporosis goes away as it did in this case, it's called transient osteoporosis. Women in the last three months of pregnancy and middle-aged men appear to be affected most often by this condition. The hips are painful first but other joints can be affected.
More study is needed to find ways to treat transient osteoporosis. This is especially true during pregnancy when there's a risk of fracture and the risks associated with cesarean section.
Francis Y. P. Ma, MBBS, and Michael Falkenberg, MBBS, FRACS. In Clinical Orthopaedics and Related Research. April 2006. No. 445. Pp. 245-249.
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