Representative atypical femur fracture radiograph. A 65‐year‐old female patient was taking bisphosphonates for 6 years, with 6 months of progressive prodromal thigh pain. She had seen an orthopedic surgeon 1 month prior to the fracture with pelvic x‐rays showing no evidence of significant osteoarthritis at the time. Note the periosteal thickening of the lateral cortices (black and white arrows), noncomminuted transverse fracture, and the medial cortical spike (big arrow) that are typically seen in atypical femur fractures.(  26  ) 