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Introduction. Idiopathic transient osteoporosis of the hip is a rare but underdiagnosed condition. It is common in middle-aged men and pregnant women. The exact etiology is unknown.

Aim. We present a 52-year-old man presented with progressively increasing pain left hip for two months.

Description of the case. The radiograph showed osteoporosis localized to the proximal femur. Magnetic resonance imaging showed bone marrow edema. He was diagnosed as a case of idiopathic transient osteoporosis of the left hip (ITOH) after ruling out other causes. He was treated nonoperatively with analgesics and rest. He was given daily calcium and monthly ibandronate 150mg. His symptoms subsided after 3 months. There was no recurrence of symptoms.

Conclusion. We present this case to describe the clinical, radiological features, diagnosis, and treatment of ITOH. Idiopathic transient osteoporosis is a rare condition. It is often not diagnosed because of a lack of awareness and also being a self-limiting condition. The radiogram may be normal. So a high index of suspicion is needed for its diagnosis.