一過性大腿骨頭萎縮症の治療経過中にRegional Migratory Osteoporosisの診断に至った1例

Transient Osteoporosis of the Hip, Ultimately Diagnosed as Regional Migratory Osteoporosis. Case Report

　今回われわれは股関節痛で発症し一過性大骨頭萎縮症(TOH)と診断したものの，保存的治療の経過中に多発性の骨萎縮症を呈した稀な症例を経験したので報告する．症例は41歳の男性で，左股関節痛を主訴に当院を紹介され受診し，TOHと診断され，保存的治療を行った．治療開始後約3カ月で左膝関節痛が出現し，その数日後には左第2－3足趾のMP関節にも同様の症状が出現した．MRI，骨シンチグフィで同部位に骨萎縮症の所見が得られ，regional migratory osteoporosis(RMO)に分類されると考えられた．文献的考察を加え報告する．

　We report a case of transient osteoporosis of the hip (TOH) in which the final diagnosis was regional migratory osteoporosis (RMO).　A 41-year-old man complained of left hip pain, and a diagnosis of transient osteoporosis of the hip was made based on the physical, X-ray, MRI, and bone scintigraphy findings.　He was treated conservatively.　Three months later he complained of left knee pain, and a few days after that he experienced left foot pain around the second and the third metatarsal joints.　We performed X-ray, MRI, and bone scintigraphy examinations and ultimately diagnosed the case as RMO.　We review the literature and discuss the differential diagnosis between TOH and RMO.