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)

 

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