Transient osteoporosis in a young non-pregnant woman: a case report with follow-up via magnetic resonance imaging

Transient osteoporosis of the hip (TOH) is a rare, self-limiting condition characterized by hip pain and bone marrow edema, typically affecting middle-aged men and pregnant women.However, cases involving non-pregnant women are uncommon.We report the case of a 34-year-old non-pregnant woman presenting with sudden-onset left hip pain after physical activity.Her medical history was unremarkable except for an asymptomatic ovarian cyst and moderate alcohol and tobacco use.Physical examination revealed pain at the end range of hip movements, with normal strength and sensitivity.Laboratory findings were within normal limits, except for elevated immunoglobulin M and mean corpuscular hemoglobin.Magnetic resonance imaging (MRI) revealed bone marrow edema without fractures, supporting a diagnosis of TOH.Conservative management, including weight-bearing limitation, anti-inflammatory medication, and physical therapy, was initiated.Monthly follow-ups with serial MRIs demonstrated gradual resolution of edema over ten months.The patient achieved significant improvement, reporting only mild pain during prolonged walking and a successful return to regular physical activity.This case underscores the importance of accurate differential diagnosis, particularly distinguishing TOH from avascular necrosis of the femoral head (ANF), which requires surgical intervention.In TOH, conservative management remains the cornerstone of treatment.