Bhakta Ankita
Obstetrics and Gynaecology, Liverpool Hospital, 75 Elizabeth Street Liverpool, NSW 2170, Australia.
Case Rep Womens Health. 2022 Feb 14;34:e00400. doi: 10.1016/j.crwh.2022.e00400. eCollection 2022 Apr.
A 40-year-old woman presented to the emergency department at 35 weeks of gestation with a six-week history of progressive bilateral hip pain and a severe decline in mobility. Initial investigations were unremarkable and magnetic resonance imaging demonstrated bilateral and extensive femoral bone marrow oedema suggestive of transient osteoporosis (TOP). The patient was managed conservatively and underwent an elective caesarean section at 37 weeks of gestation. There was a gradual postpartum improvement of the patient's symptoms and she attained independent mobility by four weeks postpartum. TOP is a rare presentation and its true prevalence is likely underestimated owing to the diagnostic challenges of the syndrome, which can cause significant delays and often missed diagnoses. It is important for clinicians to be aware of TOP in pregnant women presenting with hip pain and for them to initiate early multidisciplinary involvement to guide diagnosis and management.
一名40岁女性在妊娠35周时因双侧髋关节进行性疼痛6周且活动能力严重下降而就诊于急诊科。初步检查无异常,磁共振成像显示双侧广泛的股骨骨髓水肿,提示为暂时性骨质疏松症(TOP)。患者接受保守治疗,并在妊娠37周时进行了择期剖宫产。产后患者症状逐渐改善,产后四周时已能独立活动。TOP是一种罕见的病症,由于该综合征的诊断具有挑战性,其真实患病率可能被低估,这可能导致诊断显著延迟且常常漏诊。对于出现髋关节疼痛的孕妇,临床医生意识到TOP并尽早启动多学科参与以指导诊断和管理非常重要。