Local hyperaemia and impaired venous return with marrow oedema and increased intramedullary pressure

Aetiology

• Higher incidence in males
• 2 groups: middle age men, pregnant women in third trimester

Clinical presentation

• Progresssive groin pain over several weeks
• Difficulty weight bearing
• Usually unilateral

Investigations

• Elevated inflammatory markers
• X-ray - osteopenia of the femoral head and neck, thinning of the cortices, preserved joint pain
• MRI - gold standard
• Bone scan

Management

• Self limiting condition that resolves in 6-9 months
• Analgesia
• Protected weight (crutches) bearing to avoid stress fracture