A 65-Year-Old Female with Hip Pain After a Stumble

The Resolution

 

Differential Diagnosis

• Pathologic fracture
• Nutrient vessel
• Stress fracture
• Transverse incomplete fracture involving the lateral cortex
• Hip dislocation

Diagnosis

This patient was diagnosed with a transverse incomplete fracture involving the lateral cortex of the diaphysis of the femur without comminution. Diaphyseal cortical thickening is noted.

Learnings/What to Look for

• This injury may occur with minimal trauma
• The injury is mainly transverse, but must involve the lateral cortex
• Be vigilant for endosteal thickening or diaphyseal thickening

 

Pearls for Urgent Care Management and Considerations for Transfer

• Provide supportive care for pain and refer for orthopedic care or arrange transport to the ED
• Intramedullary nailing is a minimally invasive method of treatment that leads to earlier mobilization and shorter hospital stay

 

Acknowledgement: Images and case provided by Experity Teleradiology. (www.experityhealth.cm/teleradiology)