The picture is of either avascular necrosis or transient osteoporosis. Initial reaction would be partial weight bearing and observe in 4 to 6 weeks with a follow up clinical examination and MRI. If still the bone oedema is present core decompression could be an indication. Vit D levels may give you some answers as well.
This young lady had a very low level of Vitamin D and very high PTH. The xray gave a hint of insufficiency fracture on the left side.
Debute of primary or secondary hyperparathyroidism should be taken into consideration. What are the serum levels of calcium, phosphor and alkaline phosphatase ?
Dear Raju,
Biochemistry has to be corrected and as Panayot is mentioning hyperparathyroidsm is playing a serious role. About the potential fracture that you are mentioning a CT possibly it will be more clear than the MRI which it is done. This way in high resolution and thin cuts it will be possible to observe the trabecular lines and the possible fracture.
Thank you. We were convinced that This insufficiency lesión was due to vitamin D deficiency, with associated secondary hyper parathyroidism. She was rherefoee treated with high dose of vitamin D and calcium. Only 2months of theray resolved her symptoms fully and vitamin D, PTH levels also became normal. The xray revealed a healed insufficiency lesion
Totally agree with the diagnosis. Even the MRI showed marrow edema epicentered in femoral neck region with some sparing of Subchondral head area
Regardless the diagnosis, just palpate the lateral upper aspect of her right arm (shoulder - humeral area) until you find tender points. Acupuncture of these tender points will immediately dissipate the left hip pain. Leave the acupuncture needles for at least 1h and if necessary repeat the acupuncture as frequent and as long as necessary.
- Badges
- Science topic
- Similar topics
- Biological Science
- Anatomy
- Tissue