Transient osteoporosis of the hip: successful treatment with teriparatide.
A 62-year-old man presented with a 2-month history of increasing pain in the left hip. Magnetic resonance imaging (MRI) showed bone marrow edema (BME) of the left femur, dual energy X-ray absorptiometry (DXA) showed osteopenia at the same level, whereas pelvis X-rays failed to show any objective findings. After ruling out other possible causes of BME such as aseptic osteonecrosis, infectious arthritis, primary or metastatic malignancy, tuberculosis, osteomyelitis, rheumatoid arthritis, and seronegative spondyloarthropathies, a diagnosis of transient osteoporosis of the hip (TOH) was made, and treatment with teriparatide at a daily dose of 20 μg was started and continued for 4 weeks. Disappearance of the symptoms and normalization of MRI were obtained.
Institute of Internal Medicine, Angiology and Arteriosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy. glfabbriciani@tiscali.it
Gianluigi
G
Fabbriciani
Matteo
M
Pirro
Maria Rosaria
MR
Manfredelli
Massimo
M
Bianchi
Silvio
S
Sivolella
Anna Maria
AM
Scarponi
Elmo
E
Mannarino
D015502:Absorptiometry, Photon; D018771:Arthralgia / Q000209:etiology; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001855:Bone Marrow Diseases / Q000209:etiology; D004487:Edema / Q000209:etiology; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019379:Teriparatide / Q000627:therapeutic use*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D050071:Bone Density Conservation Agents; D019379:Teriparatide