Review Question - QID 5993

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Idiopathic Transient Osteoporosis of the Hip (ITOH) QID: 5993 (SAE07HK.33)

QID 5993 (Type "5993" in App Search)

A 58-year-old man reports a 2-month onset of groin pain with no history of trauma. Examination reveals that range of motion of the hip is mildly restricted, and he has pain with both weight bearing and at rest. An MRI scan is shown in Figure 20. Treatment should consist of

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protected weight bearing and anti-inflammatory drugs.

53%

386/728

core decompression of the femoral head.

13%

92/728

vascularized free fibular grafting to the femoral head.

17/728

bipolar hemiarthroplasty of the hip.

28/728

total hip arthroplasty.

27%

200/728

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The MRI findings show highly increased signal through the entire femoral head and neck on STIR imaging, diagnostic of transient osteoporosis of the femoral head. This disease entity can be seen in middle-aged men, and should be treated nonsurgically. The natural history is that of self-resolution.