The authors report atypical findings of discordant bone scans and radiography seen in a patient with transient osteoporosis of the hip (TOH). Presented in the case of a 60-year-old man who had spontaneous onset of left hip pain which worsened for 2 months with weight-bearing on the affected side. Initial and follow-up radiographs of the let hip were normal. Bone scan demonstrated intense uptake of Tc-99m MDP in the affected femoral head and neck, corresponding to characteristics of abnormal signal intensity of TOH or transient bone marrow edema syndrome on MRI. This discordant pattern of bone scan and radiographs has rarely been reported in the literature. Its possible mechanism of causation and clinical implication in TOH, together with a review of the literature, are discussed in this report.
I. Hart refers to pain or other unpleasant circumstances. Other writers refer to suffering and deprivation. We use pain as a shorthand term to incorporate references to all these terms. See H.L.A. HART, PUNISHMENT AND RESPONSIBILITY 4-5 (1968). 2. It may be objected that, because many wrongful acts constitute both torts and crimes, the consequences of failure to justify the distinction are not serious. This objection is unfounded because society must justify treating those acts as both torts and crimes. If the offender is liable to pay compensation, and compensation is a morally sufficient response to a given form of conduct, then how is the additional burden of punishment to be justified? 3.
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