Dr. Richard G. McCollum: An 18-year-old girl was admitted to a neighboring teaching hospital with a one-year history of pain in the lower left side of her back, left hip, and left thigh. She reported that this had been steadily progressive over the past 12 months. Two months prior to the current admission, her case had been evaluated in another hospital with a series of roentgenograms including a lumbar myelogram, all of which were normal.
Results of physical examination on admission were normal except for the left leg. There was mild induration and increased warmth of the outer aspect of the left thigh just below the hip joint. The proximal left thigh measured 2 cm larger in diameter than the right and was slightly tender to palpation.
Laboratory data were normal except for the following: hemoglobin value, 9.3 gm/100 cc; corrected sedimentation rate, 32 mm/hr. Roentgenograms were normal except for
Aufranc OE, Jones WN, Turner RH. Pathologic Fracture of the Proximal Femur. JAMA. 1967;199(5):329-333. doi:10.1001/jama.1967.03120050071016