Bilateral femoral neck stress fractures

Case contributed by Dr Matt Skalski

Presentation

Soccer player with bilateral hip pain which is becoming increasingly severe on the left.

Patient Data

Age: 55
Gender: Male

Bilaterally there is increased cortical thickness of the medial femoral necks with a linear area of central lucency, worse on the left. The left femoral neck also demonstrates cortical irregularity which is most offset at the intersection with the lucent line. 

There is redemonstration of the findings seen on the x-ray, with thickening of the medial cortex of the femoral necks bilaterally which contain a linear central lucency, worse on the left.

Bilaterally there are low T1/STIR-weighted signal lines within the medial portions of the femoral necks, with surrounding hyperintense STIR signal within the left femoral neck. There is associated mild surrounding soft-tissue edema on the left as well, but no evidence of retracted tendon
tear. 

Bilaterally there is circumferential moderate osteophyte formation of the acetabuli and femoral head-neck junctions with complex multifocal degenerative masseration of the right and left labrum. 

Case Discussion

Nondisplaced acute stress fracture of the left femoral neck, and chronic stress fracture of the right femoral neck.

Remember that stress fractures are caused by abnormal stress on normal bone, where as insufficiency fractures are due to normal stress on abnormal bone. 

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Case information

rID: 28666
Case created: 6th Apr 2014
Last edited: 18th Aug 2017
Inclusion in quiz mode: Included

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