Transient Familial Factor V Leiden-Linked Hip Osteoporosis. / Osteoporosis transitoria de cadera familiar ligada al factor v de Leiden.

INTRODUCTION: Transient osteoporosis of the hip (THO) is a rare disease of unknown pathogenesis that has traditionally been considered an early and reversible stage of avascular necrosis (AN). Thrombophilia or familial hypofibrinolysis is considered a risk factor for the development of AN and THO. Factor V Leiden is one of the most common hereditary hypercoagulability disorders. CLINICAL CASES: Case series study. The development and course of 3THO cases in 3siblings (two males and one female) aged between 40 and 43 years are described consecutively. Clinical and nuclear magnetic resonance imaging (MRI) studies confirmed the diagnosis of THO and ruled out the presence of AN. The G1691A mutation of factor v Leiden was positive in all cases. The clinical and radiological outcome was favourable, with healing without sequelae and disappearance of bone oedema on control MRI at 6 months in all cases. DISCUSSION: The results of this study support the ischaemic aetiology and establish HTO as an early and reversable stage of hip AN. Factor V Leiden causes a state of hypercoagulability and hypofibrinolysis that encourages the development of THO due to ischaemic causes. CONCLUSIONS: This study outlines the first familiar description of factor v Leiden-linked THO.

Total hip arthroplasty for tuberculous coxitis.

We report a case of tuberculous arthritis of the hip in a 22 year old male patient, treated with arthrotomy and antituberculous antibiotic therapy for 9 months; the joint deteriorated and 2 years later he underwent uncemented total hip arthroplasty. He received antibiotic therapy for 3 months preoperatively and for 6 months postoperatively. At 5 year follow-up there was no evidence of recurrent infection.

Transient osteoporosis of the hip.

We report four cases of transient hip osteoporosis studied between 1995 and 1997. All patients were men. The diagnosis was based on clinical symptoms, absence of abnormal laboratory tests, increased uptake in the femoral head and neck on Tc-99 bone scans and magnetic resonance imaging showing Oedema of the bone marrow. In three patients radiographs showed osteopenia of the head and neck of the involved femur, whereas no major radiographic changes were seen in the fourth patient. The clinical symptoms lasted 7 months and there was no recurrence after 8-24 months' follow-up.