Presentation
Left leg pain. No trauma. History of osteoporosis.
Patient Data




Transverse proximal left femoral shaft fracture with medial "beaking".
Thickening of the lateral shaft cortex on the right.

Increased uptake in the lateral cortex of the proximal femoral shafts bilaterally.
Case Discussion
Typical appearances of an atypical femoral fracture related to bisphosphonate use on the left with a stress fracture on the right. This patient had a history of taking bisphosphonates for osteoporosis. Recognition of these types of fractures is important because changes are usually bilateral and prophylactic pinning is often performed.