Unveiling risk factors for transient osteoporosis of the hip in Middle-Aged Men: Insights from a Cross-Sectional...

To identify clinical, environmental, and lifestyle-related risk factors for transient osteoporosis of the hip (TOH) in men, compared with a control group of men without TOH and peripartum women with TOH.

This retrospective cross-sectional study included men aged ≥ 18 years who underwent pelvic/hip MRI for hip pain at a tertiary care center between 2010 and 2023. Among 231 men, 31 (13.4 %) were diagnosed with TOH. Prospective data were collected via telephone questionnaire. Controls included 190 men without TOH (questionnaires administered to an age-matched subgroup of 31) and a previously described cohort of 34 women with peripartum TOH. Data on demographics, medical history, physical activity, occupation, vitamin D/calcium supplement use, and corticosteroid exposure were analyzed.

Men with TOH were significantly younger than controls (45.4 vs. 57.3 years; P = 0.006) with higher BMI (29.62 vs. 28.24p = 0.03) and more frequently reported vitamin D/calcium use (58.1 % vs. 10 %; P < 0.001). They tended to have more physically demanding occupations, higher activity levels, and more childhood dental issues (P > 0.05). Compared to women with peripartum TOH, men were older, had a similar BMI at symptom onset, a greater corticosteroid use, and a lower prevalence of family history of osteoporosis. Patients consulted an average of 3.7 physicians before diagnosis. Symptoms resolved within 3-6 months in most cases, and MRI findings normalized within 2-11 months.

TOH in men is underrecognized and may be associated with mechanical overload and altered bone turnover. Identifying potential risk factors may aid in earlier diagnosis and management.