Transient osteoporosis in the third trimester of pregnancy: A case report

A 40-year-old woman presented to the emergency department at 35 weeks of gestation with a six-week history of progressive bilateral hip pain and a severe decline in mobility. Initial investigations were unremarkable and magnetic resonance imaging demonstrated bilateral and extensive femoral bone marrow oedema suggestive of transient osteoporosis (TOP). The patient was managed conservatively and underwent an elective caesarean section at 37 weeks of gestation. There was a gradual postpartum improvement of the patient's symptoms and she attained independent mobility by four weeks postpartum. TOP is a rare presentation and its true prevalence is likely underestimated owing to the diagnostic challenges of the syndrome, which can cause significant delays and often missed diagnoses. It is important for clinicians to be aware of TOP in pregnant women presenting with hip pain and for them to initiate early multidisciplinary involvement to guide diagnosis and management.