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Pseudopathologic hip fracture: anatomic explanation.

T R Duncan, A J Gerlock, C A Muhletaler

    AJR. American Journal of Roentgenology
    |October 1, 1980
    PubMed
    Summary
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    Hip fractures can cause external rotation of the femur, making the bone appear dense, especially in older women. This visual artifact, caused by cortical thickness variations, must be differentiated from a pathologic fracture.

    Area of Science:

    • Radiology
    • Orthopedic Surgery
    • Medical Imaging

    Background:

    • Hip fractures are common, particularly in elderly individuals.
    • External rotation of the femoral diaphysis can occur following hip fracture.
    • This displacement can lead to characteristic changes in radiographic appearance.

    Purpose of the Study:

    • To describe the radiographic appearance of the proximal femoral diaphysis following hip fracture.
    • To explain the underlying cause of the homogeneous density observed in some cases.
    • To differentiate this appearance from that of a pathologic fracture.

    Main Methods:

    • Review of radiographic and computed tomography (CT) findings in patients with hip fractures.
    • Analysis of femoral diaphysis morphology and cortical thickness variations.

    Related Experiment Videos

  • Comparison with imaging features of pathologic fractures.

    • Main Results:

    • External rotation of the femoral diaphysis after hip fracture can cause a homogeneously dense appearance of the proximal diaphysis.
    • This density is attributed to variations in cortical thickness in anteroposterior and mediolateral planes.
    • Computed tomography (CT) confirms these cortical variations.

    Conclusions:

    • The homogeneously dense appearance of the proximal femoral diaphysis in the context of hip fracture is an imaging artifact.
    • Radiologists and clinicians must be aware of this finding to avoid misdiagnosis.
    • Distinguishing this appearance from a pathologic fracture is crucial for appropriate patient management.