Hip fracture diagnosed 2 month later
Hello. I am a 27-year-old canicross and bikejoring athlete. I had never had any hip problems before.
At the end of January, I had a few bikejoring falls. They were violent but not painful. The last one left my hip completely bruised purple, though it was not especially painful, just a huge hematoma.
After these falls, I started feeling pains I had never experienced before: while horseback riding, a small buck forced me to get off because of the shock in my hip.
Then, during canicross and running, I started developing hip pain. At first it only appeared at the end of training sessions, then at the end of sessions and during the following 24 hours, then 48, then 72… This all happened over about two weeks, while increasing my activity volume by only 5–10% per week (short easy outings, rarely more than 5 km, since I was preparing for a canicross race of that distance). When the pain eventually stopped going away, even walking my dogs for two hours caused hip pain. I thought it was tendinitis.
Four days after my last easy 5 km run, the pain still had not gone away. Still believing it was tendinitis, I took ketoprofen (NSAIDs) and went canicross training as usual. Warm-up: 3 km at 6:30–7:30 min/km pace, with pain already present. Then 3 km with the dogs at 3:50 min/km.
That was the moment I realized something was seriously wrong. The pain was intense, and every stride required all my concentration not to collapse to the ground.
The next morning, Day 1, I was unable to walk. Every hip movement made me scream in pain. I fainted while going to the bathroom, and eventually had to start using crutches and completely unload the leg.
I saw my general practitioner, who suspected a hip stress fracture and prescribed X-rays and an MRI. The X-ray was performed on Day 3 and was normal. The MRI was done on Day 10, and the results were received on Day 20.
Results: no stress fracture, but f emoral insertion tendinopathy of the:
- iliacus muscle
-pectineus muscle medially
-the tensor fasciae latae laterally
This surprised the doctors because, in their opinion, the hypersignal seen on the MRI looked like a massive and diffuse bone marrow edema. However, we followed what was written in the report and treated these tendinopathies.
At the beginning of April, I started physiotherapy with a specialist in sports medicine and complex locomotor disorders.
Every exercise reignited the inflammation. Every session made me limp. She tried everything: isometric exercises, massage, stretching. Yet there was absolutely no improvement — on the contrary, the pain worsened.
After four sessions together, she advised me to stop and undergo a CT arthrogram with injection of corticoid, both to calm the inflammation and especially to look for femoroacetabular impingement or a labral tear, because in her opinion it was impossible to have such a progression without an underlying structural issue.
I should mention that my physiotherapist and doctor worked together closely on this case, and my doctor agreed to prescribe the exam.
Yesterday, May 7th, after two months of injury, I underwent the injection followed by the CT arthrogram to investigate this suspected hip impingement.
The radiologist came to speak with me afterward to ask for my MRI report and especially the MRI images, because they immediately found a fracture on the CT arthrogram. I had the images on my phone. He was outraged that the massive bone marrow edema had been completely ignored in favor of the small tendinopathies (which were what the written report focused on), leading to inappropriate management for a femoral neck fracture.
Here is the report:
“Posteromedial basicervical cortical stress fracture with a 6 mm incomplete anterosuperolateral deep labral fissure, without labral cyst.”
Now I feel completely lost. My doctor freaked out when she learned this. She wants me to see a specialist as soon as possible in order to put a strict unloading or even immobilization protocol in place, because I have spent two months walking, cycling, stretching, and strengthening on this fracture without knowing it.
I have an appointment on June 1st with an extremely specialized surgeon, and in the meantime I managed to get another appointment on May 11th with a less specialized surgeon, mainly to establish a temporary management plan until then.
I know the initial injury partly resulted from my own mistakes. I never imagined it could become this serious. I work as cabin crew, and I’m afraid I could eventually lose my job due to medical unfitness. I can no longer properly take care of my dogs. I had just adopted my future canicross champion, who will turn 12 months old in September, and I feel like I may never be able to run again.
Has anyone experienced something similar?
The fracture is still relatively small (it does not completely cross the bone), but in cases like this, can surgery still sometimes be recommended to protect it? And what about the 6 mm labral fissure?
Thank you for your feedback.