Bilateral transient osteoporosis of the hip with asynchronous onset during pregnancy: a case report

Transient osteoporosis of the hip is a rare condition characterized by temporary bone loss in the femoral head, leading to severe hip pain and walking difficulties. This report presents the case of a 39-year-old pregnant woman (gravida 4, para 0) who developed right hip pain and claudication at 33 weeks of gestation. Magnetic resonance imaging revealed right-sided transient osteoporosis. To mitigate the risk of femoral fracture during vaginal delivery, a scheduled cesarean section was performed at 38 weeks. Immediately postpartum, the patient experienced left leg pain, and a subsequent scan confirmed a new onset of transient osteoporosis in the left femoral head, establishing a diagnosis of asynchronous bilateral disease. Given the persistent decrease in bone mineral density and vitamin D deficiency, early weaning and rehabilitation were initiated. The patient's symptoms and bone density gradually improved over three months. This case underscores the importance of evaluating atypical hip pain in pregnancy and highlights the necessity of cautious postpartum follow-up, including nutritional support and early weaning to prevent fractures.