MRI of transient osteoporosis of the hip

Abstract

Among the available imaging techniques such as conventional radiography, radionuclide bone scan, and computed tomography (CT), magnetic resonance imaging (MRI) has made significant contributions to the diagnosis of acute hip joint disease in adults by enabling early differentiation between such conditions as idiopathic avascular femoral head necrosis, septic coxitis, degenerative disease, and tumors. In this study we investigated the use of MRI for evaluation of patients with transient osteoporosis (TO). MRI with T1- and T2-weighted sequences in coronal, transverse, and sagittal sections was performed in 12 patients with retrospectively confirmed TO, both at the onset of the disease and later as follow-up procedure. MRI revealed three typical stages of TO: a diffuse stage, a focal stage, and a residual stage. Characteristic symptoms of TO are hip pain and a need for protective splinting of the hip joint. Conventional radiographs show demineralization of the hip joint without joint space narrowing. Clinical, radiologic, and MRI findings normalize within 6-10 months, indicating that TO has a good prognosis with complete restoration of bone density.

MR Evaluation of Non-Traumatic Hip Pain

“…A follow-up MRI after 3 months was normal thereby confirming the diagnosis. Grimm J et al [19] in their study on TOH described typical stages of TOH with normalization of MR findings within 6 to 10 months. Malizos KN et al [20] described that absence of subchondral lesions and sparing of subchondral zone from marrow edema were MR findings that highly correlate to TOH.…”

Transient Osteoporosis of the Hip and Hyperbaric Oxygen Therapy: A Report of Two Cases

“…Characteristic bone marrow edema changes can appear 48 h after the onset of symptoms (2). In MRI, its differential diagnosis with avascular necrosis, which causes focal lesions in the subchondral region, must be made (6,7). Radiological findings can continue to be observed even weeks after the improvement of symptoms (7).…”

Transient bone marrow oedema of the foot

“…It shows the joint space integrity, the extent of local demineralization and excludes other pathological conditions [9]. MRI is the diagnostic method of choice for TBME [1,6,11,21]. Forty-eight hours after the start of the symptoms the characteristic oedema-like signal pattern of the bone marrow can be observed.…”