Clinical Indicators Used to Identify Femoral Neck Bone Stress Injuries: A Scoping Review

Femoral neck bone stress injuries (FNBSI) are a significant problem among soldiers in the U.S. Military. The trainee military population experiences stress fractures at a rate of 43.75 per 1,000 person-years. This scoping review aimed to summarize the available evidence regarding the clinical findings to indicate FNBSI. This information can be used to better guide clinical decision making and identify gaps in current research concerning the diagnosis of FNBSI in clinical settings.

This study included any article who provided information on the method of clinical diagnosis specific to FNBSI with subjective or objective measures. This was completed with exclusion of articles in non-English language, utilized cadavers or non-human subjects, were intervention or surgical procedure based, included pediatrics, or related to injuries other than a FNBSI. We retrieved subjective and objective clinical indicators who could aid in the diagnosis of FNBSI. We summarized our findings by case study, cohort, and systematic review.

The most common publication type concerning clinical indicators for the diagnosis of FNBSI were case reports (n = 30, 58%). This was followed by cohort studies (n = 20, 38%), and systematic reviews (n = 2, 4%). Common clinical indicators of FNBSI within the literature were an increase in physical activity and insidious pain at hip or groin.

This review can be utilized in future studies to inform clinicians of commonly identified clinical indicators of FNBSI and more appropriate utilization of diagnostic imaging in the diagnosis of FNBSI.