Hip Warning in Elderly

In a prospective study, 26.3% of elderly subjects developed hip pain before their fracture. Study concluded that people should be questioned about appearance of new symptoms. “A better recognition of “prefracture” pain in the elderly may allow adequate management and treatment of patients, in order to avoid a proportion of hip fractures.” Question is, what could one do?

Clin Exp Rheumatol. 2008 May-Jun;26(3):464-6.
Prefracture syndrome of the hip fracture: a case control study.
Fleury M, Briot K, Jenn J, Dubois M, Roux C, Gauvain JB.
abstract here

If one were to treat this as a transient arthritis hip then there are some suggestions in the literature:

Intravenous pamidronate in the treatment of transient osteoporosis of the hip .
Bone , Volume 31 , Issue 1 , Pages 96 – 101;
July 2002
M . Varenna

Thirteen men and three women (mean age 38.3 years, range 30–49) were recruited.

Pamidronate (45 mg) was intravenously administered three times, once every third day
“These results suggest that a short course of pamidronate is effective in treating TOH, and leads to a prompt and long-lasting recovery.”

Also Calcitonin (intranasal here) might be helpful:

    Calcitonin in the Treatment of Transient Osteoporosis of the Hip .
    Seminars in Arthritis and Rheumatism , Volume 32 , Issue 6 , Pages 388 – 397 June 2003
    T . Arayssi
It would seem obvious that Vitamin D might be low. If so, Osdo 50,000 IU (generic osteoforte that is no longer available) once weekly could bring up levels fast. Calcium supplementation.
Even parathyroid hormone might be a consideration.
One would think one should be very careful until the pain is better but that could take weeks!
Any ideas on the subject?
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