Femoral neck fracture and dermoid cyst

Case contributed by Dr Matt Skalski

Presentation

Undisclosed.

Patient Data

Age: 40
Gender: Female

There is a transcervical (bordering on basicervical) fracture of the right femoral neck with resultant coxa vara deformity. This fracture appears non-comminuted. Two dense calcific structures are observed in the pelvic basin to the right of mid-line which are vaguely tooth shaped. Two 1cm in diameter sclerotic lesions are noted in the right and left ilii bordering the sacroiliac joints, most likely representing bone islands

The right L5 trasverse process is large and spatulated, and creates a pseudoarticulation with the right sacral ala. At this site an obliquely oriented lucent line with corticated margins is also noted, possibly creating another non-articular motion segment. The left L5/S1 facet joint is moderately hypertrophied and sclerotic indicating facet arthrosis, likely related to the contralateral pseudoarticulation. 

Annotated image

The tooth-shaped calcific structures are indicated by the blue arrows. The bone islands are indicated by the green arrows. The articulating left L5 transverse process is indicated by the yellow arrow. 

Case Discussion

The ovarian dermoid cyst was confirmed on a subsequent pelvic MR.

This case is useful to train satisfaction of search, as one may be satisfied with identifying and describing the femoral neck fracture and overlook the multiple other findings. 

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Case information

rID: 37050
Case created: 24th May 2015
Last edited: 18th Sep 2015
Inclusion in quiz mode: Included

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