“ First described as transient demineralisation of the femoral head in women in the third trimester of pregnancy, it is also known to affect...
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First described as transient demineralisation of the femoral head in women in the third trimester of pregnancy, it is also known to affect middle-aged men. It causes hip pain and resolves without treatment after weeks to months. Related syndromes include migratory regional osteoporosis and transient bone marrow oedema.
Generally, only one hip is affected at a time. Recurrence in the same hip is possible.
An insufficiency fracture is a possible complication.
PLAIN FILM
• Radiographic features lag behind clinical features.
• Osteopenia of the femoral head seen 4-8 weeks after symptom onset.
• Loss of subchondral cortex of the femoral head is the hallmark.
• No joint space narrowing or subchondral bone collapse.
• Joint effusion.
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• Homogeneously increased uptake on bone scan.
MRI
• Bone marrow oedema (i.e. low T1, high T2), which is most intense in the subchondral bone of the femoral head and which fades as it extends down the femoral neck.
• Diffuse enhancement of the abnormal marrow post-contrast.
• Small effusion.
Transient osteoporosis of the hip. Pelvic x-ray demonstrating osteopenia of the left femoral head with no joint space narrowing.
Transient osteoporosis of the hip. STIR coronal magnetic resonance image demonstrating bone marrow of the left femoral head and neck.
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