PMC2817495_01
X-ray taken at first presentation of thigh pain on the right side. There is a sign of discrete lateral cortex thickening.
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fig1
The only abnormality found was a thickening of the medial and lateral cortex of the right femur with a discrete local periostal reaction on the lateral cortex (Figure 1).
The subtrochanteric fracture through the lateral cortex thickening with a medial spike.
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fig2
The fracture was located at the same spot as the cortical thickening (Figure 2).
PMC2817495_02
Cortical thickening (arrow) at the site of the pain in the left thigh.
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fig3
Radiological examination at that time showed a thickening of the medial and lateral cortex of the left femur with a discrete local periostal reaction on the lateral cortex (Figure 3).
The subtrochanteric fracture through the thickening of the lateral cortex with a medial spike.
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fig4
Additional radiological examination showed a transverse femur shaft fracture (Figure 4).
PMC2817495_03
Thickening of the lateral cortex (arrow) at the site of the pain in the left thigh.
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fig5
Radiological examination of the pelvis and left upper-leg showed a thickening of the medial and lateral cortex with a discrete thickening of the cortex on the lateral side of the proximal femur (Figure 5).
SPECT of the lesion on the left femur showing bilaterally thickened cortices and both internally and externally intact cortices. On the left side the bone scan showing a hotspot on the lateral side of the left femur.
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fig6
The cortex was intact both internally and externally and showed increased thickness (Figure 6).
Fracture through the thickening of the lateral cortex with a medial spike.
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fig7
This turned out to be a transverse subtrochanteric fracture through the cortical thickening with a medial spike (Figure 7).
Subtrochanteric fracture in the same patient as Figures 5 and 6 on the contra-lateral side. The fracture has the exact same pattern.
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fig8
The patient had been suffering from pain in her right thigh for two weeks and had sustained a spontaneous subtrochanteric fracture of the right femur while walking (Figure 8).