ABSTRACT
INTRODUCTION: Idiopathic Transient Osteoporosis (ITO) is a rare entity that may occur during pregnancy, usually manifesting in the third trimester and is considered a diagnosis of exclusion. When present in the hip, it is usually characterized by joint pain, claudicating gait, and osteoporosis of the femoral head with preservation of the joint space. These early clinical and radiological signs may be confused with those of aseptic necrosis, infection, or bone tumors, making it important to exclude these differential diagnoses. Complete resolution of this condition is usually prolonged and may take anywhere from 6 months to 1 or 2 years. CASE REPORT: This article presents the case of a 48-year-old Caucasian pregnant woman who presented a non-traumatic left hip pain. After the exclusion of infectious and tumoral diseases, a diagnosis of a less probable transient idiopathic osteoporosis was suspected. Magnetic resonance imaging images after childbirth supported this diagnosis. She recovered clinically and imagiologically with no complications 2 years after delivery. CONCLUSION: Rarely, hip pain during pregnancy can occur due to transient osteoporotic injuries in the proximal femur. It is more frequent during the third trimester and although it resolves spontaneously in the following months after childbirth, we should always be aware of these less likely diagnoses.
ABSTRACT
INTRODUCTION: In recent years, growing evidence of the association between bisphosphonate use and incidence of atypical femoral fractures has emerged. Cases of peri-implant fractures associated with bisphosphonate use suggest the emergence of a new clinical entity because they are not currently covered by the definition of atypical femoral fracture. CASE REPORT: We present here two rare clinical cases treated in our hospital. Two women (68 and 76 years old) with peri-implant (cephalomedullary nail) fractures and history of prolonged bisphosphonate use (11 and 14 years). Both fractures occurred after minor trauma and showed an atypical fracture pattern. One of the patients underwent revision osteosynthesis and had a 12 months follow-up. The second patient was submitted to orthopedic treatment and had a 6months follow-up. CONCLUSION: Although reports of periprosthetic fractures and peri-implant(plate and screws) have been published, references to peri-implant cephalomedullary nail fractures were not found in the literature. Here, we question if these fracture types should be included in the current definition of atypical femoral fracture, or form a new clinical entity.
