Rapid Destructive Coxopathy.

A woman in her 80s with hypertension and dyslipidemia was transported to our department because of severe pain on her right hip of three months’ duration. Although she had had no destruction of her hip one year before this event (Picture 1), computed tomography revealed atrophic destruction involving the femoral head and acetabulum (Picture 2). These findings suggestive of fracture involving the femoral head were the first clue leading to the diagnosis of this case. Imaging studies revealing disappearance of the femoral head in the hip joints are key in the differentiation of diseases with symptoms of hip pain from rapid destructive coxopathy, an uncommon subset of osteoarthritis. It is difficult to detect such fracture on radiographs taken at the onset of pain, but even at such an early stage, recent studies have reported that magnetic resonance imaging (MRI) clearly shows subchondral fracture (1). The early decision to perform MRI and refer patients to an orthopedist is essential for an early diagnosis and intervention, including total hip arthroplasty.

Picture 1.

Picture 2.

The author states that he has no Conflict of Interest (COI).