Case 4 - “The Hipster”
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| MRI Pelvis and Hips (Image 1) |
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| MRI Left Hip (Image 2) |
The first MR image of the whole pelvis shows a bright area (short arrow) representing inflammation and edema (excess fluid) in the left femoral neck, the narrow part of the hip bone just below the round femoral head (the “ball” of the hip joint). The enlarged, second MR image better demonstrates a dark line extending transversely across the femoral neck (arrow). Neither of these findings could be seen on the plain x-rays.
DIAGNOSIS: Femoral neck stress fracture.
Unfortunately, our runner has developed a stress fracture of her left femoral neck. The presence of a fracture line indicates more than just a stress reaction. Left unchecked, this fracture line could propagate across the femoral neck resulting in a displaced fracture, which would require surgery. Our somewhat dejected runner is given strict orders to refrain from weight-bearing on the left leg (including running!) along with a nice pair of crutches. After a few weeks, our runner will be able to transition to walking without crutches then to light exercise and eventually back to running. In the meantime, she will work with her sports medicine physician and running coach to identify any potential underlying risk factors such as low bone mineral density or excessive/improper training.
Dean Thornton, MD
Inside the Runner uses medical imaging to offer readers a chance to see what is going on inside their bodies when something breaks down. From fractures to tendonitis to muscle injuries, this series explores the imaging studies used to help doctors and other medical professionals treat running injuries.
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DIAGNOSIS: Femoral neck stress fracture.
Unfortunately, our runner has developed a stress fracture of her left femoral neck. The presence of a fracture line indicates more than just a stress reaction. Left unchecked, this fracture line could propagate across the femoral neck resulting in a displaced fracture, which would require surgery. Our somewhat dejected runner is given strict orders to refrain from weight-bearing on the left leg (including running!) along with a nice pair of crutches. After a few weeks, our runner will be able to transition to walking without crutches then to light exercise and eventually back to running. In the meantime, she will work with her sports medicine physician and running coach to identify any potential underlying risk factors such as low bone mineral density or excessive/improper training.
Dean Thornton, MD
Dean is a Musculoskeletal Radiologist with Radiology Associates of Birmingham and a Clinical Associate Professor of Radiology at UAB. He works with many local orthopedists and sports medicine physicians. He also likes to run.
Inside the Runner uses medical imaging to offer readers a chance to see what is going on inside their bodies when something breaks down. From fractures to tendonitis to muscle injuries, this series explores the imaging studies used to help doctors and other medical professionals treat running injuries.