Stress fracture of femoral dyaphysis mimics osteosarcoma

Abstract

Stress fractures of the femur are relativly uncommon. They can mimic other pathological entities, such as tumors, and can be the sourse of some diagnostic problems. The cause of stress fractures is often multifactorial and various modifiable and non-modifiable factors have been proposed to play a role: ethicity, high bone turnover, vitamin D insufficiency, nicotine and alcohol abuse, steroid use, low bone density, low adult weight, anorexia, or bisphosphonate therapy. Hence they might be missed in other groups of patients that present with anterior thigh pain without history of significant trauma. We report a stress fracture that mimicked tumoral process of the long bone, but patho-histological analysis revealed that it was a non-specific inflammation. Symptoms often mislead the clinicians, and because they mimic other conditions, a high index of suspicion/indication is required to uncover the true diagnosis. The importance of early detection and management needs to be conveyed, with a view to prevent complete fracture and bonedisplacement or, asin our reported case, to avoid un-necessery exploration.