A Case Report of an “Incidental” Neck of Femur Fracture

INTRODUCTION: On rare occasions, hip fractures can be missed. Approximately 75,000 neck of femur fractures occur in the United Kingdom per annum. Up to 10% of hip fractures are occult on plain radiograph. This case demonstrates a usual presentation of an “incidental” neck of femur fracture, which had been missed 1 year prior. CASE REPORT: A 91-year-old gentleman presented with incidental finding of left neck of femur fracture on a routine radiograph. A quick review of the patient notes revealed a fall, with a lengthy hospital admission, approximately 1 year previously. Despite his initial inability to weight-bear and protracted slow progress with physiotherapy no further imaging of the hip was obtained beyond an initial, negative pelvic radiograph. CONCLUSION: Doctors must be bold in questioning a radiograph that does not fit with the clinical picture. Clinical suspicion of neck of femur fracture in the face of a negative radiograph necessitates further imaging to obtain a definitive answer.