The patient was a 72-year-old woman who presented to an emergency department with a chief complaint of severe right thigh pain following a fall. Prior to the fall, the patient reported an 8-month history of worsening right thigh pain. The patient had a 4-year history of alendronate and calcium use to manage her osteoporosis. Dual X-ray absorptiometry (DXA) hip images taken 1 month prior to the patient’s fracture demonstrated lateral cortical thickening in the subtrochanteric region of the femur. In retrospect, this finding was concerning for impending complete fracture.

J Orthop Sports Phys Ther 2012;42(1):44. doi:10.2519/jospt.2012.0402

KEY WORDS: bisphosphonates, bone mineral density, dual X-ray absorptiometry, DXA, radiography, thigh pain