A Case of Bilateral Transient Pregnancy-Related Osteoporosis of the Hip Diagnosed Late During the Lactation Period: A Rare Clinical Presentation and a Mini Review of the Literature

TL;DR

A rare case of bilateral hip osteoporosis during lactation is reported, with late diagnosis and successful treatment after stopping breastfeeding.

Contribution

This paper presents a rare clinical case of bilateral transient pregnancy-related osteoporosis diagnosed during lactation and provides a literature review.

Findings

The patient's condition was diagnosed via MRI after symptoms persisted postpartum.

Treatment with bisphosphonates led to full remission three months after discontinuing breastfeeding.

The case highlights the importance of recognizing this rare condition for better maternal and fetal outcomes.

Abstract

Transient pregnancy-related osteoporosis of the hip is a rare, idiopathic, benign, and usually self-limiting condition caused by edema of the bone marrow, which can be visualized on magnetic resonance imaging. Bilateral localization of the disease is even less common. Our case concerns a 31-year-old primigravida who, during the 35th week of pregnancy, was hospitalized at the Obstetrics and Gynecology Clinic of the General Hospital of Trikala with lumbar and hip pain. The pain gradually increased in intensity and was accompanied by severe movement limitation. No history of falls or injury was reported. Her personal history was unremarkable, and the course of the pregnancy was uneventful. A clinical examination by a team of orthopedic surgeons established a diagnosis of acute hip and back pain. Rest and administration of paracetamol did not improve her clinical condition. During the postpartum and lactation period, the lack of symptom relief led to the decision to further evaluate the patient. The diagnosis of pregnancy-related transient osteoporosis of both hips was established by magnetic resonance imaging. Immediate treatment with bisphosphonate medication after the discontinuation of breastfeeding led to a definitive remission of the symptoms three months later. In this study, after the case description, a brief literature review of this rare clinical entity is presented. Proper knowledge of this condition helps to provide the best possible short- and long-term prognostic outcomes for the mother, fetus, and newborn.

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