Lateral pain in the thigh

Abstract

An 84-year-old woman receiving long-term bisphosphonate therapy presented with subacute lateral thigh pain without significant trauma. Radiographs demonstrated characteristic features of an atypical subtrochanteric femoral fracture, including lateral cortical beaking, a transverse fracture line, and minimal comminution. MRI confirmed associated bone marrow edema and periosteal reaction. The patient underwent prophylactic intramedullary nailing to prevent fracture completion. Bisphosphonate therapy was discontinued, and osteoporosis management was reassessed. At three-month follow-up, radiographs demonstrated progressive callus formation without displacement, accompanied by substantial clinical improvement. This case highlights the importance of early recognition and intervention in bisphosphonate-associated atypical femoral fractures.