Young man with sudden severe hip pain secondary to femoral neck stress fracture

Abstract

Femoral neck stress fractures have been described in military recruits and athletes. Early recognition and aggressive treatment are important, as femoral neck stress fractures have a high potential for complications and even uncomplicated fractures require an extensive course of rehabilitation. Tension-side (superolateral) stress fractures of the femoral neck are at high risk for complications such as displacement, non-union and avascular necrosis, and need to be treated surgically, while compression-side (inferomedial) fractures can be treated conservatively. We describe a case illustrating a typical presentation of insidious hip pain culminating in sudden onset of severe hip pain in a healthy young man. We perform a literature review of studies showing epidemiology, treatment algorithms and rehabilitation.

Figure 1

MRI of the left hip demonstrating moderate marrow oedema surrounding a linear hypointense area of T1 and T2 signal abnormality consistent with a non-displaced compression-type posterior femoral neck stress fracture.