Transient Hip Osteoporosis: What Happens Over Time?

In this article, orthopedic surgeons from Israel report on the natural history of transient hip osteoporosis. Natural history refers to what happens in the disease process and in the bone over time. Osteoporosis is a decrease in bone density potentially leading to weak and brittle bones. Transient means it's temporary. The condition resolves or gets better over time.

Transient osteoporosis of the hip is rare but not unknown. There are certain groups of people affected most often. These include middle-aged men (ages 30-60) and pregnant women (during the third trimester). This doesn't mean other people can't develop this problem. Cases of transient osteoporosis of the hip have been reported in teenagers and women who aren't pregnant. Such cases are very rare.

How would you know if you had this problem? First, symptoms of sudden hip and groin pain develop that get worse and cause the person to limp. The pain is severe enough to send the patient to the doctor. But X-rays and blood work are normal. The painful symptoms last several weeks to several months. The changes in bone go away gradually, usually within a year's time.

MRIs are really needed to make the diagnosis. The authors of this study found that out by following a group of 37 men and women with this condition. The patients ranged in ages from 21 to 75 years old. None of the women in this study were pregnant. Although the left hip is affected most often during pregnancy, in this group of nonpregnant individuals, there was an equal distribution between right and left hips. A few of the men went on to develop transient osteoporosis of the other hip.

The investigators took X-rays and MRIs periodically throughout the course of treatment. Imaging studies were repeated during follow-up that extended over a period of years (up to nine years). X-rays did not show any evidence of osteoporosis or other changes to identify the problem. Bone scans suggested osteonecrosis alink_delimiter_one_string (death of bone) in the head of the

Reference: 

Itai Holzer, et al. Transient Osteoporosis of the Hip: Long-Term Outcomes in Men and Nonpregnant Women. In Current Orthopaedic Practice. March/April 2009. Vol. 20. No. 2. Pp. 161-163.

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