Stress fracture of femoral neck-MRI

Case Report: 15 yr old girl with pain left hip region with no history of significant trauma displays linear incomplete line of altered signal in the femoral neck inferior surface consistent  with stress fracture of compression variety.

Teaching points by Dr MGK Murthy, MRI technologist: Mr Afroz

• Stress fractures of femoral neck are uncommon and  usually  unilateral and seen in military recruits and athletes with unusual physical activity demands. Women more often involved  and in  post menopausal  women,osteoporosis may play a role.  Xray may not demonstrate.  If symmetrical, bilateral  incomplete fractures seen  , osteomalacia is the first possibility

• Stress fractures are of two varieties (a) superior surface involvement  called tension fractures can and do  progress  and displace 
  (b) Inferior surface fracture called  compression  variety  is stable and shows callus on all modalities  usually 

• MRI is good modality to show  linear fracture line and   marrow edema on either side . Bone scan is also diagnostic like  other locations in cases of stress fracture  including occult variety