Presentation
Sudden thigh pain, no history of trauma.
Patient Data
Right-sided obliquely oriented minimally displaced intertrochanteric fracture, likely Evans type 4 (three-part fractures with posteromedial cortex comminution), lesser trochanter avulsion/comminution, the bone marrow at the fracture edge show permeative lytic/soft tissue density areas signifying pathologic fracture.
Segmental irregular wall thickening of the sigmoid colon (the segment measure at least 10 cm with a single wall measurement of 10 mm encroaching the lumen however no proximal intestinal obstruction), hairy serosal surface with nodular fat stranding signifying locally advanced disease, few lymph nodes seen in its vicinity with pelvic peritoneal reflection thickening.
Case Discussion
Feature of pathologic fracture, the sigmoid thickening which passes unnoticed by the orthopedic was an incidental finding since the patient didn't complain of malena or constipation. He was discharged after managing his fracture, and no further workup was done.
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