Idiopathic Transient Osteonecrosis of the Hip(ITOH) Flashcards
describe the pathophysiology of idiopathic transient osteonecrosis of the Hip(ITOH)
local hyperaemia and impaired venous return with marrow oedema and increased intramedullary pressure
what clinical features are seen in the presentation of ITOH
progressive groin pain over several weeks, difficulty weight bearing, usually unilateral
what groups of people is ITOH usually seen in
males > females, middle age men, pregnant women in their third trimester
what investigations are used for ITOH
elevated ESR, radiographs, MRI(gold standard), bone scan
what is seen on the radiograph of an ITOH patient
osteopenia of the head and neck, thinning of cortices, preserved joint space
what is involved in the management of ITOH
self-limiting condition resolves itself in 6-9months, analgesia, protected weight bearing to avoid stress fracture
describe what tochanteric bursitis is
when repetitive trauma caused by iliotibial band tracking over trochanteric bursa, causes inflammation of bursa
what groups of people is trochanteric bursitis usually seen in
females, young runners, older patients
that clinical features are seen in presentation of trochanteric bursitis
pain on lateral aspect of hip, pain on palpation of greater trochanter
how is diagnosis of trochanteric bursitis made
clinically, MRI can be done but not usually needed
what is involved in the management of trochanteric bursitis
analgesia, NSAIDs, physio, steroid injection
no proven surgery benefit
