An Unusual Cause of the Transient Osteoporosis of the Femoral Head: Essential Thrombocytosis

Altan M., Bayram S., Salduz A., Özmen E.

Journal of Orthopaedic Case Reports, vol.9, no.1, pp.41-44, 2019 (Peer-Reviewed Journal)


Introduction: Transient osteoporosis(TO), also known as bone marrow edema syndrome, is characterized by marrow edema which causes increasing of intramedullary pressure. Among the other causes, such as 3rdthird-trimester pregnancy, impaired circulation may also be caused by changes in normal blood counts such as thrombocytosis. There are multiple reports in the literature of secondary femoral head TO transient osteoporosis; however, there is no case report of femoral head TO transient osteoporos is specifically secondary to essential thrombocytosis (ET) in literature. Herein, we present ET essential thrombocytosisas an unusual cause of TO transientosteoporosis of the femoral head.

Case report: A 33-year-old male presented himself to our clinic with severe left hip pain. The patient has painful hip motions and itching after the bath and episodic chest pain. Family history is positive for hematological malignancy. Complete blood count (CBC)test showed an increased level of thyrombocytes and haematology opinion obtained. The genetic analysis was positive for Janus kinase 2JAK2V617F and patient was diagnonsed as ET essential thrombocytosis. Besides, to eliminate the symptoms of the hip, the surgical intervention had planned and the patient had a dramatic pain relief during follow-up.

Conclusion: ET Essential thrombocytosisis a myeloproliferative disorder and has a good prognosis. TOTransient osteoporosis could be accompanied with hematologic disorders, especially myeloproliferative diseases. Based on our review of literature, this is the first case with ETessential thrombocytosis and TO transient osteoporosis of the hip.