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Femoral neck Stress Fractures

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I was in basic training in later part of 2012 when I started getting pains in my left (dominant) knee. The DS told me it was from over work. I continued to work out with the pain when I began having pains in my right hip. The hip pain came after falling three times because my left knee gave out during a run. I went to the hospital and had an X-ray. The results where negitive. The doctor had a suspicion about the cause of the pains and ordered a bone scan. I was diagnosed with a severe stress fracture to the femoral neck in the right leg, mild stress fracture to the femoral neck in the left leg, and hot focal points in the left and right knees according to what I remember on the report. I was put on crutches,which I was on till I got discharged two months later and remained on them for another month after, and told to use my left leg since it was the less severe of the two. Two weeks later, I noticed a loud, deep popping sound in my left hip area when I would raise my knee to my chest and the same after lowering it. Pain always followed with the popping. Also, when moved to the side with my knee bent at about a 90 degree angle, a cracking noise that sounds like popping all of your knuckles at the same time during the raising and lowering to the left, and also when tightening my legs together. Pain also associated each time. I never got a chance to ask a doctor on base about it. Pain continued in my left knee, one on the inseam of the leg at the joint, about the circumference of a quarter, and another just below the knee cap. After discharge, I was taken off the crutches because I was developing shoulder problems, months later I found out they where way too high by another doctor after breaking my toe in an unrelated incedent, and was not put on any other walking device. I have recently had an X-ray and an MRI of my left hip and knee, results where negative from what I was told. They won’t do a bone scan, which was the only thing that showed problems the last time, because they don’t find a reason to. I was also put on physical therepy, relucently by the doctor and only after complaining they weren’t doing anything but giving me pain medication, and even the PT acknowledged that I should not be cracking and popping, especially associated with pain, but can only continue the PT because the doctor ordered it. My doctors, including the PA who did my exam but said he consulted with the orthopedic doctor and found nothing wrong, same doctor that ordered the PT, have even acknowledged this, but either don’t know why or say they find nothing wrong. It has been a year and the problem has not changed and if anything getting worse. It is very difficult to walk without pain, and it does effect my sleeping. Pain medications seem only to make it less painful, but still hindering. I would like to know what the possibilities could be, on both the hip and knee, and what other test can be done. I’m going through the VA and regretably can’t afford a second opinion. Also any suggestions on resources to look at to find what procedures can be done to correct the possible problems so I at least have a reference to point to when talking to my Ortho on what to do. I’m on regular PT for hip and knee and will be doing aquatics in Dec until Mar, when I see the Ortho again. I need help because I’m tired of the problem being acknowledged, but nothing really being done about it. I can provide documents or more information if needed to help.


2 comments

    May PT

    9 10

    Wow, you’ve been through the gamut. First of all do you think it would be advantageous to have a lawyer that specializes in medical issues to review your medical records? Second, with some femoral neck fractures we see necrosis of the femoral head. There is a blood vessel that supplies the head of the femur and sometimes when there is a fracture it causes trauma to that nerve thereby cutting off the supply to the femoral head causing death of the bone to that area. Are you still having hip pain, specifically in the groin region of the side affected? I’m not saying that is what it is, I’m just explaining a complication that can come from a neck fracture. Word to the wise for you…if it hurts don’t do it. If PT hurts for goodness sake don’t do it! Can you at least see a different doc on the VA system. I wish you the best of luck. Mya

      Avatar

      9 10

      Well, the VA hospital won’t let me get a second opinion, VA issue regretably. I’m nervous to get another Doc, because the way Ortho treated it. They where supposed to be the second doctor and really didn’t do much but a short exam, and based thier dicision off the x-ray and MRI films only. But I’m still having pain, not in where I would consider the groin, but when you sit, at the bend in the middle,about three inches to the left of the groin, and the pain will shoot down my leg, more severe when it pops. also on the outside side of the leg, same respect on height as the groin. As far as AVN, they said that the MRI results didn’t show any signs of it, But I still have the pain and the popping/cracking. According to my C&P exam (before even seeing a doc or ortho at the VA) the results of the bonescan on base was this:{exam date: Jun 02, discharge date: Jan 24) “This veteran is 69″ tall, weighs 210 pounds, 180 one year ago and 145 five years ago. He had no bone and joint problems prior to enlistment. While in basic training in fort jackson, SC he developed pain in the rihgt hip. He was studied with X-rays which were negative and after that a bone scan of the pelvis and below reported definite stress fractures not in the head but in the neck of the femur, left and right, and definate stress fractures in both the left and right medial tibial plateaus. The Medical Board that was convened apparently acted on reports of wheezing and coughing with running and I did not find a medical board report relating to the bone and joint problems”
      “Examination was carried out of his hips and his knees and the findings are severe and extremely limiting in the left hip, moderate medial surface of the left knee and then mild right hip and right knee. He can stand although now the recent injury to his left toe makes it difficult for him to stand. He did allow a customary examination of both knees. I found noperiarticular thickiening in either. He can extend both to 0 position but when he does he gets pain while sitting extending the right knee to 150 degrees. After that, Flexion on the right easily goes to 130 Degrees, on the left is limited to 115 Degrees. McMurray’s sign is negative right and left. Lachman sign is negative right and left. No ligament laxity and no valgus or varus instability were found in either knee. No crepitus was felt in either knee. Both patellas are movable with no significant pain or tenderness on the right and very mild pain and tendernesson the left.”
      “Examination of the hips revealed that standing and lying supine he can extend each hip to 0 position full extension. He can flex the right hip while lying supine with mild pain to 115 Degrees.. Flexing of the left hip results in moderate pain at 60 degrees and severe pain at 75 degrees so we didn’t go any further. The same with medial bending, lateral bending, internal and external rotation he can tolerate it with only minimum of discomfort right side, but he gets significant pain in and around the left hip joint and the left greater trochanter with any motions on the left.”
      “IMPRESSION Stress Fractures beginning on active duty as follows: a. Left femoral neck, now with moderately severe limitation of range of motion by pain. b. Medial plateau of the left tibia, now with mild pain and mild limitation of range of motion by pain. c. Right femorial neck with minimal pain and minimum limitation now. d. Right medial tibial plateau with minimal pain and minimal limitation of range of motion. I think it is much more likely than not that these problems are a continueation of stress fractures that occured incident to basic training at fort jackson, SC. and have continued since discharge. Current hip and knee xr’s are completely normal. With regard to employability, the left hip pain and limitation of motion have rendered him unemployable for anything other than a sit down position.”
      X-ray reports on X-rays done the same day: ” Report: pelvis and both hips impression: AP views of the pelvis in nutral and frog-leg positions reveal no evidence of fracture or dislocation. The hips have a similar appearance bilaterally. The joint spaces maintained bilaterally. The sacroiliac joints are open. There is a spina bifida occulta of S1.” “report: standing knees impression: no evidence of fracture or dislocation either knee. The knees have a similar appearance. The joint spaces are mantained in respect to each knee and articular margins are smooth. The posterior articulating margins of each patella are smooth. No prior films.”
      Hopefully this might help.

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