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Transient osteoporosis of the hip with underlying subchondral fracture

Case contributed by Sherif Ismail
Diagnosis almost certain

Presentation

Persistent left hip pain with limitation of movements

Patient Data

Age: 40 years
Gender: Male

Diffuse area of altered marrow signal intensity is seen involving the left femoral head creeping inferiorly to the inter-trochanteric region including the neck, exhibits edema pattern showing low T1 and non-uniform bright T2 and PDFS signal intensities associated with femoral head subchondral linear low signals in all sequences consistent with fracture, synovial thickening, mild joint effusion, in addition to abnormal signals eliciting low T1 and high PDFS signals within the surrounding muscles consistent with muscular edema. Yet normal left femoral head spherical contour and smooth outline with no evidence of cortical irregularity or structural collapse.

Mild right-sided hip joint effusion and diffuse subcutaneous fat edema.

Case Discussion

Transient osteoporosis of the hip is a relatively rare disorder characterized by loss of bone tissue in the proximal femur. The hip joint is the most common location of the disease, although it may also involve the knee, ankle or foot bones.

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