Abstract
Femoral neck fractures occur in approximately 6,000 of young adults annually (ages 18-49) (1). Of these, a high-energy traumatic event is the typical cause. Although medications and chronic diseases have been implicated as confounding causes of hip fractures, clinicians should have a high index of suspicion for an oncologic etiology of hip fractures occurring in young patients without an inciting traumatic event.Study Design: A case report and literature search in the English language.
Highlights
Medications and chronic diseases have been implicated as confounding causes of hip fractures, clinicians should have a high index of suspicion for an oncologic etiology of hip fractures occurring in young patients without an inciting traumatic event
Long-term use of steroids leading to osteoporosis and increased risk of fractures has been well documented in the literature [5-7]
In addition to corticosteroid use, the patient had a history of using proton pump inhibitor (PPI) medications for several years prior to presentation
Summary
A patient with multiple medical comorbidities and long-standing osteoporosis due to high-dose corticosteroid use sustained a low-energy hip fracture. A 29 year-old African-American female presented late one evening to a community hospital emergency department with severe right hip and groin pain She stated the pain occurred during ambulation at a local store. Radiographs were performed of the pelvis, hip, and sacroiliac joints (see Fig. 1) She was diagnosed with a ‘hip strain’ and referred to outpatient physical therapy and primary care physician follow-up. While in the emergency room, the patient initially had a CT scan of her right hip that revealed a minimally displaced femoral neck fracture as seen in Fig. The patient has continued multispecialty surveillance of her adenocarcinoma of unknown origin by the general surgery and gastroenterology teams with no other lesions or progression being noted
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