Compression type stress fracture of femoral neck with equivocal X-ray features diagnosed on (99m)Tc-MDP SPECT/CT in a case of trivial hip pain

Stress insufficiency fracture is usually diagnosed clinically and on the basis of routine X-ray imaging findings. However, the absence of any known predisposing factors and negative or occult radiographic findings pose diagnostic challenges. We report the case of an elderly male patient who presented with a chief complaint of trivial left hip pain and with equivocal radiographic findings. Triphasic (99m)Tc-methylene diphosphonate bone scan and single-photon emission computed tomography/computed tomography helped in arriving at the diagnosis of stress insufficiency fracture involving femoral neck.