Transient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesis
Abstract Background Transient osteoporosis of the hip (TOH) is a rare and temporary clinical condition characterised by bone marrow edema (BME), severe pain, and functional limitation. It commonly occurs in middle-aged men or in women in the last trimester of pregnancy. TOH usually resolves with con...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12891-020-03574-x |
| _version_ | 1819205396577910784 |
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| author | Marco Paoletta Antimo Moretti Sara Liguori Matteo Bertone Giuseppe Toro Giovanni Iolascon |
| author_facet | Marco Paoletta Antimo Moretti Sara Liguori Matteo Bertone Giuseppe Toro Giovanni Iolascon |
| author_sort | Marco Paoletta |
| collection | DOAJ |
| description | Abstract Background Transient osteoporosis of the hip (TOH) is a rare and temporary clinical condition characterised by bone marrow edema (BME), severe pain, and functional limitation. It commonly occurs in middle-aged men or in women in the last trimester of pregnancy. TOH usually resolves with conservative therapy but may predispose to hip fracture or progression to avascular necrosis (AVN). Etiology is still unclear, although several pathophysiological mechanisms underpinning this condition has been proposed. We describe the management of an unusual case of TOH occurred in a patient with subclinical hypothyroidism. Case presentation A clinical case of a 46-year-old man with severe pain in the left anterior thigh is presented. After a comprehensive clinical and radiological approach, a TOH was diagnosed. Moreover, biochemical assessment suggested the presence of subclinical hypothyroidism. After 3 months of treatment with clodronate, physical therapy and hormone replacement therapy (HRT) a significant improvement of clinical and radiological outcomes was observed. Conclusion Several pathological conditions have been related to development of TOH. In our case, we suggested for the first time a role of subclinical hypothyroidism as novel contributory factor for the onset of this condition, providing pathophysiological mechanisms and a scientific rationale for pharmacological treatment. |
| first_indexed | 2024-12-23T04:51:02Z |
| format | Article |
| id | doaj.art-b37855d61f164767b08c159f5e20b9ab |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-23T04:51:02Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-b37855d61f164767b08c159f5e20b9ab2022-12-21T17:59:27ZengBMCBMC Musculoskeletal Disorders1471-24742020-08-012111610.1186/s12891-020-03574-xTransient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesisMarco Paoletta0Antimo Moretti1Sara Liguori2Matteo Bertone3Giuseppe Toro4Giovanni Iolascon5Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”Abstract Background Transient osteoporosis of the hip (TOH) is a rare and temporary clinical condition characterised by bone marrow edema (BME), severe pain, and functional limitation. It commonly occurs in middle-aged men or in women in the last trimester of pregnancy. TOH usually resolves with conservative therapy but may predispose to hip fracture or progression to avascular necrosis (AVN). Etiology is still unclear, although several pathophysiological mechanisms underpinning this condition has been proposed. We describe the management of an unusual case of TOH occurred in a patient with subclinical hypothyroidism. Case presentation A clinical case of a 46-year-old man with severe pain in the left anterior thigh is presented. After a comprehensive clinical and radiological approach, a TOH was diagnosed. Moreover, biochemical assessment suggested the presence of subclinical hypothyroidism. After 3 months of treatment with clodronate, physical therapy and hormone replacement therapy (HRT) a significant improvement of clinical and radiological outcomes was observed. Conclusion Several pathological conditions have been related to development of TOH. In our case, we suggested for the first time a role of subclinical hypothyroidism as novel contributory factor for the onset of this condition, providing pathophysiological mechanisms and a scientific rationale for pharmacological treatment.http://link.springer.com/article/10.1186/s12891-020-03574-xCase reportTransient osteoporosis of the hipHypothyroidismDiphosphonatesRehabilitation |
| spellingShingle | Marco Paoletta Antimo Moretti Sara Liguori Matteo Bertone Giuseppe Toro Giovanni Iolascon Transient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesis BMC Musculoskeletal Disorders Case report Transient osteoporosis of the hip Hypothyroidism Diphosphonates Rehabilitation |
| title | Transient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesis |
| title_full | Transient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesis |
| title_fullStr | Transient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesis |
| title_full_unstemmed | Transient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesis |
| title_short | Transient osteoporosis of the hip and subclinical hypothyroidism: an unusual dangerous duet? Case report and pathogenetic hypothesis |
| title_sort | transient osteoporosis of the hip and subclinical hypothyroidism an unusual dangerous duet case report and pathogenetic hypothesis |
| topic | Case report Transient osteoporosis of the hip Hypothyroidism Diphosphonates Rehabilitation |
| url | http://link.springer.com/article/10.1186/s12891-020-03574-x |
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