Transient Osteoporosis of the Hip

Description

Dr Jonathan Vigdorchik gives his insights whilst discussing the diagnosis and management of transient osteoporosis of the hip, particularly in a male patient in his mid-40s presenting with hip pain. Dr Vigdorchik explains how an MRI can reveal swelling in the femoral head and neck, which may initially suggest avascular necrosis but is often the result of transient osteoporosis. Key imaging findings include a bright appearance of the femoral head and neck on a coronal T2 MRI scan. The management strategy emphasized is weight-bearing limitation, with the recommendation of using crutches and transitioning to 'toe touch' weight bearing to prevent potential complications like femoral neck collapse or fracture. He notes that other treatments like bisphosphonate therapy have been ineffective and that surgical intervention is only warranted if there's a prior history of stress fractures. Follow-up recommendations include a structured return to weight bearing based on pain levels and duration of crutch use.

DOI: 10.1302/3114-251149

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