Regional migratory osteoporosis and transient osteoporosis of the hip: are they all the same?

Abstract

We hypothesized that regional migratory osteoporosis (RMO) and transient osteoporosis of the hip (TOH) terms describe a common disease process. Therefore, based on our patient, we aimed to review the pathogenesis, diagnosis, and treatment of both diseases. The patient was a pregnant woman in her third trimester with sacral insufficiency fracture, which was shortly followed by migratory arthralgia of both hips and ankles in a proximal to distal direction. She was operated (core decompression) for both hips and ankles, and she was symptom free at 17th month. RMO and TOH have an unclear etiology, share the similar course, and bear a self-limiting nature. Both disorders may be the same clinical entity with a common pathogenesis. Probably, many of RMO patients were labeled as TOH, and therefore, RMO has been underrepresented. In conclusion, we think that both RMO and TOH describe a common disease process. Either the diagnosis is RMO or TOH, the management will be the same. Finally, the conservative treatment protocol is a better treatment modality and must be obeyed even in resistant cases.

MR imaging of transient osteoporosis of the hip: An update on 155 hip joints

“…It is nowadays accepted that RMO constitutes a progression of TOH [13,15,16] with studies proposing a common pathophysiology between the two entities [17]. Cahir et al [15] have proposed that 72% of TOH patients progress to RMO during the first year after their diagnosis.…”

“…Several case reports and patient series describe TOH as a disease mostly affecting patients during the fourth decade of their life [2,3,12,13], with a male predominance and a predilection for left hips. Our results confirm the above data with an approximately 3:1 male:female ratio.…”

Migratory transient osteoporosis: atypical migration to the bilateral knee after childbirth

“…With insufficiency of intake calcium added to the scene, a negative balance is created and this may trigger TO. [15] Insufficient calcium intake was seen in our case, which increased risk factors for this disorder. [1,14] Transient osteoporosis can be recovered from spontaneously.…”

“…[1,14] Transient osteoporosis can be recovered from spontaneously. [15] It has also been reported that TO was improved by the termination of pregnancy in severe cases that do not respond to the other treatment. [16] Interestingly in our case, a remission was not seen during the postpartum period and migration occurred other joints.…”

Magnetic Resonance Imaging of the Hip

“…The etiology of regional migratory osteoporosis is also unknown, although some authors have suggested that transient osteoporosis of the hip and regional migratory osteoporosis reflect the same underlying process. 106 …”