Pathologic basicervical hip fracture

Case contributed by Stefan Tigges
Diagnosis certain

Presentation

Right hip pain after a fall.

Patient Data

Age: 50 years
Gender: Male

Minimally displaced basicervical right hip fracture with destruction right proximal femur. Additional lytic lesion extends from the anterior superior iliac spine to the anterior inferior iliac spine.

Confirms minimally displaced basicervical right hip fracture with mild varus angulation and destruction right proximal femur. Multiple other lytic lesion are present.

Nuclear medicine

Bone scan shows multiple areas of increased uptake consistent with metastatic disease to bone.

Pathology results

Photo

Biopsy showed that the source of the bone metastses was the prostate gland

Case Discussion

This basicervical femoral neck fracture occurred in an area partially destroyed by metastatic disease, therefore it is a pathologic fracture. The biopsy indicated that the source was the prostate gland: the vast majority of skeletal metastases due to prostate cancer are sclerotic, not lytic as in this case.

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