Longitudinal stress fracture of the femur
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We present the case of an 80 year old woman with hip pain, caused by a longitudinal femoral insufficiency stress fracture, depicted with radiographs, CT and MR. This type of fracture is very rare, with only a few cases reported. We conducted a literature review and compared the findings with the present case.

Case Report
An 80 year old woman, with history of Type 2 Diabetes Mellitus, congestive heart failure and hypertension presented with left hip pain of two weeks duration. There was no history of trauma or unusual physical activity, and the pain worsened with weight bearing and any limb movement, alleviating with rest. Range of motion of the hip was globally limited, due to pain. Conventional radiography was performed in the emergency department, showing a medial intracortical hypodense vertical line in the femoral shaft, immediately below the small trochanter. This finding, in association with the clinical presentation, prompted the diagnosis of insufficiency stress fracture, however its vertical orientation was clearly not typical. CT scan and MR imaging were performed, confirming the presence of a longitudinal intracortical stress fracture of the medial aspect of the femoral diaphysis, just below the small trochanter.

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