Idiopathic Transient Osteoporosis of the Hip: A Frequently Overlooked and Misdiagnosed Cause of Hip Pain.

Idiopathic transient osteoporosis of the hip (ITOH) is a rare and self-limiting condition of unknown origin, typically responding well to conservative treatment. It is characterized by progressive pain, claudication, and osteoporosis of the femoral head, while the joint line remains preserved. Early clinical and radiological findings can be misinterpreted as aseptic necrosis, infection, or neoplastic processes, making careful exclusion of these conditions essential. In this report, we describe the case of a 55-year-old male presenting with left-sided hip pain without any preceding trauma. After ruling out other potential conditions, ITOH was suspected, and the patient was successfully managed conservatively. ITOH continues to be a poorly understood and frequently overlooked clinical entity. Despite advancements in imaging techniques, its diagnosis remains challenging and often depends on exclusion. This case highlights the importance of recognizing and discussing ITOH in clinical practice.