Department of Radiology, Eastern Virginia Medical School, Norfolk (Drs. Trace, Hoang, and McMonagle); Hampton Roads Radiology, Norfolk, Va (Dr. McMonagle) JScottMcM@gmail.com
DEPARTMENT EDITOR Richard P. Usatine, MD University of Texas Health Science Center at San Antonio
The authors reported no potential conflict of interest relevant to this article.
This case was presented, in part, at the Radiological Society of North America Annual Meeting in 2014 by Dr. Hoang.
While this patient had osteoporosis, she hadn’t experienced any recent trauma or falls that would explain her pain.
A 63-year-old woman with a 3-year history of osteoporosis presented to our clinic with a 2-week history of severe right hip pain. She had been taking a bisphosphonate—oral ibandronate sodium, 150 mg, once monthly—for about 6 years. The postmenopausal patient had a history of degenerative disc disease and lumbar back pain, but no known history of recent trauma or falls.
A clinical exam revealed full passive and active range of motion; however, she had pain with weight bearing. A full metabolic panel revealed no significant abnormalities. A leg length discrepancy was noted, so a bone length study was ordered. Anteroposterior x-rays of the bilateral lower extremities demonstrated a focal convexity along the lateral cortical junction of the proximal right femur (FIGURE).
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