It is important to trace the lines of the femoral neck on hip radiographs to identify a cortical step defect, as can be seen on the frontal and lateral projections. The frontal projection also shows a thin sclerotic line traversing the femoral neck, representing the impacted fracture fragments.
Of note, this patient has a false negative John Thomas sign, with the penis pointing towards the right hip rather than the pathological left hip. This sign, although commonly referred to, is not supported with robust evidence in the literature, as demonstrated in a recent meta-analysis1.