A 45-year-old woman experienced mysterious hip pain that didn’t show up on standard X-rays, making diagnosis difficult. Doctors discovered she had a stress fracture—a tiny crack in her hip bone caused by repeated stress rather than a fall or injury. The case is unusual because stress fractures in this location typically affect older women or those taking certain medications. Using advanced MRI imaging and blood tests, doctors confirmed the fracture and treated it without surgery by limiting weight-bearing activity for several weeks. The patient recovered completely within six months, highlighting the importance of advanced imaging when standard tests appear normal but pain persists.

The Quick Take

  • What they studied: A single case of a stress fracture in the upper thigh bone of a middle-aged woman without obvious risk factors, examining how doctors diagnosed and treated it
  • Who participated: One 45-year-old woman with no previous major health conditions, experiencing progressive hip and thigh pain over six weeks
  • Key finding: MRI imaging revealed a stress fracture that standard X-rays completely missed, and conservative treatment (rest, limited weight-bearing, and calcium/vitamin D supplements) led to complete healing in six months
  • What it means for you: If you have persistent hip or thigh pain that doesn’t improve with rest and standard X-rays appear normal, ask your doctor about MRI imaging. This case suggests that stress fractures can occur in younger women without obvious risk factors, and early detection through better imaging can prevent the need for surgery

The Research Details

This is a case report—a detailed medical story about one patient’s experience. A 45-year-old woman came to the hospital complaining of gradually worsening pain in the inner upper part of her left thigh that had been bothering her for about six weeks. The pain got worse when she climbed stairs or squatted down, but she hadn’t experienced any injury or fall. Doctors first took regular X-rays, which looked completely normal, so they ordered an MRI scan (a detailed imaging test) to get a better look at the bone. The MRI showed a small crack in the bone with swelling around it. Blood tests and a bone density scan (DEXA) were also performed to understand why this happened.

This research approach is important because it documents a rare and unusual case that helps doctors recognize similar situations in their own patients. Case reports serve as early warning systems for medical conditions that don’t fit typical patterns. By publishing this case, the doctors alert other healthcare providers that stress fractures can happen in younger women without the usual risk factors, and that MRI is essential when X-rays appear normal but symptoms persist.

As a case report, this study describes one person’s experience rather than testing a large group. While case reports have limitations in proving cause-and-effect, they are valuable for identifying rare conditions and unusual presentations. The strength of this case lies in the detailed documentation, use of multiple imaging methods (X-ray and MRI), and clear follow-up showing complete healing. The main limitation is that findings from one person cannot be generalized to everyone.

What the Results Show

The patient presented with progressive pain in the upper inner thigh that worsened with activity and didn’t improve with rest. Initial X-rays appeared completely normal, which is typical for stress fractures in early stages. MRI imaging revealed a non-displaced stress fracture (a crack that hadn’t shifted out of position) in the subtrochanteric region of the femur (upper thigh bone) with surrounding bone marrow swelling. A bone density scan showed the patient had osteopenia (lower-than-normal bone density, but not as severe as osteoporosis), with a T-score of -2.1 at the hip. Blood tests were normal, ruling out infections, metabolic disorders, or other systemic diseases. The patient was treated conservatively with strict rest (no weight-bearing) for 6-8 weeks, followed by gradual return to activity with physical therapy, and supplementation with calcium and vitamin D.

At the 8-week follow-up, the patient reported significant pain relief and improved ability to walk and perform daily activities. A follow-up MRI at 6 months showed complete healing of the fracture with no signs of delayed healing or bone damage. No surgical intervention was needed, and the patient achieved full functional recovery. The case demonstrates that conservative management can be effective for non-displaced stress fractures even in patients with reduced bone density.

Stress fractures in this location (subtrochanteric region) are typically seen in elderly individuals with osteoporosis or in people taking bisphosphonate medications (drugs used to treat bone loss). This case is unusual because the patient was 45 years old, premenopausal (still menstruating), and not on any medications known to affect bone quality. Most published cases involve older women or those with significant risk factors. This case expands medical understanding by showing that such fractures can occur in younger women with only mild bone density reduction, suggesting that other factors (such as repetitive stress from daily activities) may play a role.

This is a single case report, so the findings apply only to this one patient and cannot be generalized to all women with similar symptoms. The case doesn’t explain why this particular patient developed a stress fracture—the underlying cause remains somewhat unclear since she lacked typical risk factors. There’s no comparison group or control group to determine what might have prevented the fracture. The patient’s specific activities and lifestyle factors that may have contributed to the stress aren’t fully detailed. Additionally, long-term follow-up beyond 6 months isn’t provided, so we don’t know if the fracture remained healed over years.

The Bottom Line

If you experience persistent hip or thigh pain that doesn’t improve with rest and standard X-rays appear normal, discuss advanced imaging (MRI) with your doctor. If a stress fracture is diagnosed, conservative treatment with rest, gradual return to activity, and adequate calcium and vitamin D intake appears effective. Women with reduced bone density should be aware of this risk and discuss bone health optimization with their healthcare provider. Confidence level: Moderate (based on one case, but supported by general orthopedic principles).

This case is most relevant to middle-aged women experiencing unexplained hip or thigh pain, healthcare providers who evaluate patients with persistent leg pain, and women with reduced bone density who want to understand potential complications. It’s also important for radiologists and orthopedic specialists to remember that stress fractures can occur in younger patients without typical risk factors. People should not assume they have a stress fracture based on this case alone—proper medical evaluation is essential.

In this case, significant pain relief occurred within 8 weeks of starting conservative treatment, with complete bone healing demonstrated by 6 months. However, individual recovery times vary. Most people can expect gradual improvement over weeks to months with appropriate treatment, but full return to all activities may take 6 months or longer.

Want to Apply This Research?

  • Track daily pain levels (0-10 scale) and specific activities that trigger or worsen pain (stairs, squatting, walking distance). Note which movements cause discomfort and monitor improvement weekly. This helps identify patterns and provides concrete data to share with your healthcare provider.
  • If diagnosed with a stress fracture, use the app to log weight-bearing activities and ensure compliance with rest recommendations. Set reminders for calcium and vitamin D supplementation, and track physical therapy exercises. Create a gradual activity progression plan with your doctor and use the app to monitor adherence and pain response to increased activity.
  • Establish a long-term tracking system that monitors pain trends, activity tolerance, and bone health markers over 6-12 months. Set monthly check-in reminders to assess functional improvements (ability to climb stairs, walk distances, perform daily tasks). Track supplement intake and any new symptoms. This data helps identify whether conservative treatment is working and informs discussions with your healthcare provider about progression to weight-bearing activities.

This case report describes one patient’s experience and should not be used for self-diagnosis. Persistent hip or thigh pain requires professional medical evaluation. If you experience unexplained leg pain, contact your healthcare provider for proper assessment, imaging, and diagnosis. Treatment recommendations should be individualized based on your specific condition, medical history, and imaging findings. This information is educational and not a substitute for professional medical advice, diagnosis, or treatment.