28F with bilateral hip pain and tightness and difficulty walking for 9 months
They don’t provide running or other sports or overuse history
The referrer ordered pelvis MRI to evaluate both hips (not hip MRI)
I am posting this partly because I don’t recall seeing bilateral concomitant femoral neck stress fractures.
The Main reason I am posting is because I am uncertain how to report this.
Do I report bilateral incomplete medial femoral neck stress fracture or stress reaction without fracture?
I know that osseous stress injury is a spectrum from grade I (periosteal edema) to grade IV (fracture, with visible cortical defect and / or linear fracture).
As a radiologist I am inclined to call this stress reaction.
BUT, a sports orthopedist who I read for frequently had me amend a report a few years ago when I diagnosed stress reaction….he told me that I should report it as Fracture…because the only way to get the patient to rest was to report fracture.
It made clinical sense, and I changed how I reported all similar lesions.
Now, in consultation with my colleague, she told me that the same orthopedist who told me to report these lesions as fracture actually yelled at her because she reported a fracture but he couldn’t see a fracture line.
Which IS IT????
How would you report this?
Hilary
