Azam Faraji - Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Zahra Shomali - OB & GYN department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
Sedigeh Yoosefi - Maternal-fetal Medicine Research Center, Perinatology Department, Shiraz University of Medical Sciences, Shiraz, Iran.

Objective:PAO is a rare condition characterized by reduced bone mineral density during the third trimester or lactation.This case helps us to recognize the PAO.Case report: A 29-year-old, gravida 1 woman developed right hip joint pain during the gestational age 34wk. Despite conservative management, pain intensified. The patient delivered a healthy neonate in 38th week of gestation and afterwards underwent magnetic resonance imaging of the pelvic, revealing a bruised bone in the femoral neck. Since she had developed femoral neck fracture during postpartum period, she underwent open reduction and fixation of femoral neck. Dual-energy X-ray absorptiometry (DEXA) revealed osteoporosis of the vertebras and femoral neck. All laboratory findings were revealed idiopathic osteoporosis in this patient. On 2-year and 4-year follow-up she was found with significant improvement in DEXA indices after treatment with Calcium and alenderonate.Conclusion: PAO is a rare condition and should be kept in mind when pregnant or postpartum woman complaints of hip or back pain that does not responded to usual medications.

PAO, femur fracture, lactation