Patient's Query
Hello doctor,
I am a 23-year-old male with 5 feet 9 inches height and 145 pounds of weight. I am of South Asian descent. Eight years ago, I was diagnosed with level 4 stress fractures in both femoral necks and level 2 stress fractures in each ankle after intense exercises during basic training. I was put on crutches and calcium supplements. I was told to avoid any physically demanding activities. Despite severe pain in my hips, thighs, and lower back, I initially sought help for a stabbing pain in my butt, which felt like a knife was digging deeper into my bone. A bone scan and MRI confirmed the injuries.
A week later, I was recommended for discharge, but I was forced to run three miles carrying a 50 pound bag. I returned to find my injuries had worsened, and surgery with pins was recommended. I opted to let the fractures heal naturally. After six months, the injuries improved, but I still experience various pains.
I occasionally feel pressure pain in both hips, starting from the pelvic bone and wrapping around the hip to the lower back. The pain can last anywhere from 30 minutes to hours, sometimes easing with rest, though sitting can also cause discomfort. I also feel sharp, pressure-like pain in my femurs, as if they are being squeezed. Walking long distances triggers sharp pains in my femur, and I have noticed swelling in my feet and minor ankle pain, though I am unsure if it is related.
I am concerned these symptoms may indicate early signs of AVN or osteoarthritis, especially since my mother has AVN and has had both hips replaced. I am worried about these persistent hip pains and whether they are signs of something more serious.
Please help.
Hello,
Welcome to icliniq.com.
I read your query and understood your concern.
Based on what you have described, I am not sure how thoroughly the condition was investigated. Did they tell you why you had stress fractures? Was there any metabolic cause, deficiency, or other underlying issue? Were any precautions suggested?
Also, I need to know: Was blood work done? For example, Vitamin D, serum calcium, alkaline phosphatase, phosphorus levels, liver function tests, or any other tests? Did you have a bone scan, CT (computed tomography) scan, or MRI (magnetic resonance imaging)?
However, given your family history and current symptoms, I believe you cannot ignore this issue. You need to find out the underlying cause and seek treatment for your current symptoms, not just symptomatic relief but definitive or curative care.
I suggest you consult with your local physician who can refer you to an orthopedic doctor and a metabolic bone disease expert. A bone scan is necessary, followed by X-rays of any areas identified as abnormal on the scan. You should also get detailed information and test results from the doctors who treated you.
Regarding your immediate concerns about avascular necrosis (AVN) or osteoarthritis, while both are possible, the likelihood of either is minimal unless your femoral neck fractures have displaced.
I hope this has helped you.
Kindly follow up with the asked information and if you have more doubts.
Thank you.
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Answered byDr. Atul Prakash
Medically reviewed byiCliniq medical review team
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