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初产妇与经产妇妊娠晚期一过性股骨头骨骺骨质疏松症

Transient peripartum osteoporosis of the femoral head in first and third pregnancy.

机构信息

Department of Orthopedic, Medical Centre of Postgraduate Education, Otwock, Poland; Physical Education Faculty in Biala Podlaska, Academy of Physical Education, Warsaw, Poland.

Department of Orthopedic, Medical Centre of Postgraduate Education, Otwock, Poland.

出版信息

J Clin Densitom. 2012 Oct-Dec;15(4):467-471. doi: 10.1016/j.jocd.2012.02.010. Epub 2012 Jun 6.

Abstract

The aim of this article was to present transient peripartum femoral head osteoporosis. This very rare condition occurred twice in our patient-a woman in her 30s. The cases described in the literature were mostly unilateral, with bilateral hip involvement noted much less frequently. In our patient, transient osteoporosis occurred in the third trimester of her first pregnancy in the right hip, her second pregnancy was uncomplicated, and in the third trimester of the patient's third pregnancy, osteoporotic changes were noted in the left hip joint. The patient breastfed her first and third babies only 3 wk each. She breastfed her second baby for 4 mo. The diagnostic workup was based on the clinical examination and radiographic/magnetic resonance imaging, which revealed bone marrow edema, and the dual-energy X-ray absorptiometry scans. The treatment consisted in core decompression of the femoral head (foragé), unloading of the hip using crutches as well as administration of calcitonin and calcium supplements. Complete recovery of the femoral heads was achieved. The follow-up time was 7 yr.

摘要

本文旨在介绍围产期一过性股骨头骨质疏松症。这种非常罕见的情况在我们的患者——一位 30 多岁的女性身上发生了两次。文献中描述的病例大多为单侧,双侧髋关节受累的情况少见得多。在我们的患者中,一过性骨质疏松症发生在她第一次怀孕的第三个月的右侧髋关节,她的第二次怀孕没有并发症,在第三次怀孕的第三个月,左侧髋关节出现骨质疏松改变。患者仅母乳喂养了第一个和第三个婴儿各 3 周。她母乳喂养第二个婴儿 4 个月。诊断依据是临床检查、影像学/磁共振成像,这些检查显示骨髓水肿,双能 X 线吸收仪扫描也显示骨髓水肿。治疗包括股骨头(foragé)钻孔减压、使用拐杖减轻髋关节负重,以及使用降钙素和钙补充剂。股骨头完全恢复。随访时间为 7 年。

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