Vanishing hips: unveiling Gorham-Stout syndrome

Gorham-Stout syndrome (GSS is ana rare disorder characterized by progressive osteolysis of unclear aetiology. It can affect various bone sites, with variable clinical presentations, being bilateral hip involvement particularly uncommon.

We report the case of a 54-year-old woman with morbid obesity and type 2 diabetes, with hip and knee osteoarthritis. For over two years, she experienced progressive bilateral hip pain and gait limitation. Plain radiographs revealed bilateral resorption of the femoral heads, absent in previous radiograms. Computed tomography showed severe acetabular dysplasia with deformity and resorption of both femoral heads. Magnetic resonance imaging confirmed bone loss and bone marrow infarction. There were no clinical or analytical features suggestive of inflammatory arthropathy, nor phospho-calcium metabolism disorder apart from vitamin D deficiency. Based on the radiological and clinical findings, a diagnosis of Gorham-Stout syndrome was considered.

This case illustrates a rare and unusual presentation of GSS with bilateral hip involvement. Due to its rarity and non-specific clinical features, GSS is often a diagnosis of exclusion. Reporting such cases is essential to increasing awareness of this rare condition.