Transient osteoporosis of the hip after bariatric surgery

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Transient osteoporosis of the hip after bariatric surgery Cierra S. Hong, BA, Michael A. Bergen, BS, Tyler S. Watters, MD Arthroplasty Today Volume 5, Issue 1, Pages 32-37 (March 2019) DOI: 10.1016/j.artd.2018.10.010 Copyright © 2018 Terms and Conditions

Figure 1 Plain films: (a) initial anteroposterior pelvis radiograph at consultation showing no abnormalities in bony structure, joint space, or bone density. Two-month follow-up plain films: (b) anteroposterior pelvis and (c) lateral pelvic radiograph showing no changes from initial consult. Arthroplasty Today 2019 5, 32-37DOI: (10.1016/j.artd.2018.10.010) Copyright © 2018 Terms and Conditions

Figure 2 MRI at initial consultation; (a) Coronal STIR with increased diffuse signal in femoral head and neck. (b) T1-weight coronal image with decreased diffuse signal in femoral head and on anterior surface. (c) T2-weighted axial image with increased homogenous signal in femoral head. Arthroplasty Today 2019 5, 32-37DOI: (10.1016/j.artd.2018.10.010) Copyright © 2018 Terms and Conditions

Figure 3 MRI at 4-month follow-up; (a) pelvis STIR coronal image with decreased intensity in femoral head and intertrochanteric region. (b) T1-weighted coronal image with resolution of decreased signal in femoral head and on the anterior surface. Arthroplasty Today 2019 5, 32-37DOI: (10.1016/j.artd.2018.10.010) Copyright © 2018 Terms and Conditions

Figure 4 Pelvis MRI of osteonecrosis; this is a different patient who presented with osteonecrosis of the L hip at the precollapse stage. The red arrow shows the “double line” sign—a pair of serpiginous low- and high-intensity bands likely caused by sclerosis. Arthroplasty Today 2019 5, 32-37DOI: (10.1016/j.artd.2018.10.010) Copyright © 2018 Terms and Conditions

Figure 5 Diagnostic algorithm for acute mechanical hip pain. ∗∗Abnormal film can consist of joint space narrowing, osteophyte formation, varus/valgus deformity, subchondral cysts, joint effusion, bony erosions, periosteal reaction, subperiosteal abscess, cortical loss, and sclerosis; ∗∗∗Can have normal plain films. Important factors for diagnosis include elevated inflammatory markers and physical examination. Arthroplasty Today 2019 5, 32-37DOI: (10.1016/j.artd.2018.10.010) Copyright © 2018 Terms and Conditions