Idiopathic transient osteonecrosis of the hip (ITOH)

Question 1

What does ITOH stand for?

Answer 1

Idiopathic transient osteonecrosis of the hip

Question 2

What is ITOH?

Answer 2

This is a condition, in which there is local hyperaemia and impaired venous return with bone marrow oedema and increased intramedullary pressure

Question 3

How will ITOH present?

Answer 3

progressive groin pain over several weeks, with difficulty bearing weight
It is usually unilateral

Question 4

Who is most commonly affected by ITOH?

Answer 4

Middle aged men
Pregnant women in 3rd trimester

Question 5

How is diagnosis of ITOH made?

Answer 5

X-ray
MRI
Blood tests
Bone scans

Question 6

What will blood testing show in ITOH?

Answer 6

Raised ESR

Question 7

What will X-ray show in ITOH?

Answer 7

Osteopenia of the head and neck
Thinning of the cortices
Preserved joint space

Question 8

How long will it take ITOH to clear?

Answer 8

6-9 months

Question 9

What management is used while ITOH is healing on its own?

Answer 9

Analgesia
Advice to protect the hip from weight bearing