Unusual presentation of a femoral stress fracture

Abstract

Stress fractures are common injuries in sports medicine. Among these fractures, femoral neck stress fractures frequently have a benign course, especially when it happens in the medial aspect of the neck. This case report describes a stress fracture of the medial aspect of the femoral neck that developed a complete fracture and underwent surgical fixation.

Figure 1

Anteroposterior radiography of the pelvis at initial presentation. This x-ray was considered normal.

Figure 2

Coronal T2-weighted fat saturated (A) and Coronal T1-weighted fat saturated postgadolinium (B) MR images of left hip demonstrating area of bone marrow oedema adjacent to the medial femoral neck cortex (arrow). Note that the area of bone marrow oedema demonstrates enhancement without focal bone lesion (arrow head). There is also mild soft tissue oedema, without evidence of cortical rupture.

Figure 3

(A) Radiographs obtained for investigation of bone metabolism disorder were considered normal. Lateral skull radiograph. (B) Tibia anteroposterior radiograph. (C) Lumbar spine lateral radiograph.

Figure 4

(A) Anteroposterior radiography of the pelvis demonstrating area of cortical thickening of to the left femoral neck cortex with linear lucency suggesting a minimally displaced fracture. (B) Coronal reformat CT image of the left hip demonstrating a minimally displaced oblique fracture of the left femoral neck cortex.

Figure 5

Postoperative radiographs demonstrating three fixation screws within the femoral neck. Note that the femoral neck stress fracture demonstrates callus formation, without deviation.