40-year-old man with right hip pain

 

Doctor's Information

Name : Morteza
Family :Sanei Taheri
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Samira Shahhamzei

 

Patient's Information

Gender : Male
Age : 40

 

Case Section

Muskuloskeletal System

 

Clinical Summary

40-year-old man with left hip pain with no special history

 

Images

 

Imaging Procedures and Findings

Coronal T1WI shows low signal in the superior portion of the right femoral head. This is a characteristic but not specific appearance for AVN.There is corresponding high signal area in coronal and sagittal PD fat saturation.(picture 1,2,3) Clinically, this patient had no underlying causes for AVN, and he was treated conservatively. Three months later, after near total cessation of the hip pain, a repeat MRI shows no abnormality in the hip. (picture 4,5,6)This is consistent with idiopathic transient osteoporosis of the hip.

 

Discussion

This poorly understood disorder is an idiopathic process that begins with a painful hip with no underlying disorder or other findings other than osteoporosis, which is limited to the painful hip. Some believe it is early AVN; however, this has not been proved. Its appearance on MR is similar to that of early AVN in that low signal on T1WIs is seen throughout the femoral head and neck. Transient osteoporosis of the hip invariably is self-limited with full resolution. It tends to occur more often in men.

 

Final Diagnosis

Transient Osteoporosis of the Hip

 

References

Brant WE, Helms CA. Fundamentals of Diagnostic Radiology, 3rd edition. P1191

 

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