Femoral Neck Insufficiency Fracture on Bone Scan
CC BY 3.0 · Jarraya et al. / Wikimedia Commons · source file
Question
This bone scan demonstrates a focus of markedly increased uptake at the subcapital region of the femoral neck in an elderly patient. Plain radiographs were negative. The MOST appropriate term for this type of fracture in an elderly patient with osteoporosis is:
- APathological fracture
- BStress fracture
- CInsufficiency fracture
- DAvulsion fracture
Show the answer and explanation
C. Insufficiency fracture
An insufficiency fracture occurs when normal physiologic stress is applied to weakened bone (e.g., osteoporosis). This distinguishes it from a stress fracture, which occurs when abnormal/repetitive stress is applied to normal bone. Bone scintigraphy is highly sensitive for these radiographically occult fractures. Pathological fractures result from a lesion (tumor or infection) weakening the bone. The subcapital femoral neck is a classic site for insufficiency fractures in elderly osteoporotic patients.
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