case_images: PMC2817495_01
case_images: X-ray taken at first presentation of thigh pain on the right side. There is a sign of discrete lateral cortex thickening.
case_images: IJR2009-253432.001.jpg
case_images: PMC2817495_01_IJR2009-253432.001.jpg
case_images: fig1
case_images: The only abnormality found was a thickening of the medial and lateral cortex of the right femur with a discrete local periostal reaction on the lateral cortex (Figure 1).
case_images: The subtrochanteric fracture through the lateral cortex thickening with a medial spike.
case_images: IJR2009-253432.002.jpg
case_images: PMC2817495_01_IJR2009-253432.002.jpg
case_images: fig2
case_images: The fracture was located at the same spot as the cortical thickening (Figure 2).
case_images: PMC2817495_02
case_images: Cortical thickening (arrow) at the site of the pain in the left thigh.
case_images: IJR2009-253432.003.jpg
case_images: PMC2817495_02_IJR2009-253432.003.jpg
case_images: fig3
case_images: Radiological examination at that time showed a thickening of the medial and lateral cortex of the left femur with a discrete local periostal reaction on the lateral cortex (Figure 3).
case_images: The subtrochanteric fracture through the thickening of the lateral cortex with a medial spike.
case_images: IJR2009-253432.004.jpg
case_images: PMC2817495_02_IJR2009-253432.004.jpg
case_images: fig4
case_images: Additional radiological examination showed a transverse femur shaft fracture (Figure 4).
case_images: PMC2817495_03
case_images: Thickening of the lateral cortex (arrow) at the site of the pain in the left thigh.
case_images: IJR2009-253432.005.jpg
case_images: PMC2817495_03_IJR2009-253432.005.jpg
case_images: fig5
case_images: Radiological examination of the pelvis and left upper-leg showed a thickening of the medial and lateral cortex with a discrete thickening of the cortex on the lateral side of the proximal femur (Figure 5).
case_images: SPECT of the lesion on the left femur showing bilaterally thickened cortices and both internally and externally intact cortices. On the left side the bone scan showing a hotspot on the lateral side of the left femur.
case_images: IJR2009-253432.006.jpg
case_images: PMC2817495_03_IJR2009-253432.006.jpg
case_images: fig6
case_images: The cortex was intact both internally and externally and showed increased thickness (Figure 6).
case_images: Fracture through the thickening of the lateral cortex with a medial spike.
case_images: IJR2009-253432.007.jpg
case_images: PMC2817495_03_IJR2009-253432.007.jpg
case_images: fig7
case_images: This turned out to be a transverse subtrochanteric fracture through the cortical thickening with a medial spike (Figure 7).
case_images: Subtrochanteric fracture in the same patient as Figures 5 and 6 on the contra-lateral side. The fracture has the exact same pattern.
case_images: IJR2009-253432.008.jpg
case_images: PMC2817495_03_IJR2009-253432.008.jpg
case_images: fig8
case_images: The patient had been suffering from pain in her right thigh for two weeks and had sustained a spontaneous subtrochanteric fracture of the right femur while walking (Figure 8).