II. Pathophysiology
- As with other Stress Fractures, overuse injury more common in female athletes
III. Risk Factors
- See Stress Fracture
- Similar risks to Pubic Ramus Stress Fracture (military recruits, distance runners)
IV. Symptoms
- Groin Pain or anterior thigh pain
- Provoked by activity (weight bearing)
- Relieved with rest
V. Signs
- Antalgic Gait
- Pain on internal hip rotation
VI. Imaging
-
Hip XRay
- XRay changes lag symptoms by 2-4 weeks
- MRI preferred over nuclear bone scan
- High Test Sensitivity (similar to bone scan)
- High Test Specificity (better than bone scan)
VII. Management
- Early diagnosis and management is critical to avoid a devastating complete Hip Fracture
- Risk Modification
- See Stress Fracture
- Image the opposite hip if Stress Fracture is found (bilateral Hip Stress Fractures are common)
- Inferior Femoral Neck Stress Fractures (medial, compressive or compression side)
- Superior Femoral Neck Stress Fractures (lateral, tensile or tension side)
- Risk of complete Fracture or Hip Avascular Necrosis
- Open reduction and internal fixation recommended
VIII. References
- Shahideh (2013) Crit Dec Emerg Med 27(9):10-18
- Morelli (2001) Am Fam Physician 64(8):1405-1414 [PubMed]
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Related Studies
| Concepts | Pathologic Function (T046) |
| ICD9 | 733.96 |
| English | Stress fracture of femoral neck, Stress fx femoral neck |
