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Stress Fracture of Hip

During running and other high impact activities, the hip joint absorbs some of the highest forces in the body. Repeated high impact activities and overuse can result in a stress fracture of the hip. A stress fracture is a break in the bone that occurs when minor injuries to the bone build up beyond the capacity of the bone to repair itself. Stress fractures of the hip are critical to diagnose and treat quickly because without treatment, they can lead to severe damage to the hip joint, even in young athletes.

A hip stress fracture is a serious injury to the ball of the ball-and-socket hip joint. Stress fractures are injuries to the bone that result from overuse activity. Fractures occur for one of three reasons:

  • High-Energy Injury
    In high-energy injuries, the bone is broken because the force acting on it was significant. These injuries would include falls, car accidents and sports injuries.
  • Stress Injuries
    A stress fracture is due to repetitive micro-trauma to the bone. Over time, the body cannot keep up with the forces acting on the bone, and a fracture eventually occurs.
  • Pathologic Injury
    In a pathologic fracture, the bone is abnormally weakened by some problem. Causes of pathologic fractures include osteoporosis, tumors and infections.

In the situation of a stress fracture, repetitive injury to the bone eventually leads to failure of the bone, or fracture. Normally, bone is constantly undergoing a cycle of turnover during which old bone is reabsorbed and new bone is created. If the process cannot keep up, eventually the bone can fracture.
Hip stress fractures most often occur just below the ball of the ball-and-socket hip joint. This location of the bone is called the femoral neck. Stress fractures can occur in other areas of the hip and pelvis, but the femoral neck is the most common, and most concerning location for a hip stress fracture.

Why Is a Hip Stress Fracture Considered a Serious Injury?

After a stress fracture, the bones often maintain their proper alignment. In fact, these fractures are sometimes not even visible — especially in the early stages — on a regular x-ray. However, if the stress fracture is left untreated, and the bone continues to weaken, the fracture can displace, or cause the bones to go out of alignment.

Hip stress fractures are particularly concerning if they displace. Because of the delicate blood supply to the bone of the hip, a fracture can lead to injury of this blood supply and a condition called hip osteonecrosis.

What Are the Symptoms of a Hip Stress Fracture?

People with a hip stress fracture are most often high-mileage runners, military recruits, or individuals doing significant impact sports activities. These athletes will typically complain of an aching groin pain that bothers them with activity, and is relieved by rest. Symptoms are usually noted after a recent increase in level of activity, such as increasing running mileage.

If a hip stress fracture is suspected, an x-ray will be performed. While some hip stress fractures will be seen on x-ray, some x-rays may appear normal. If the injury is still suspected, an MRI or bone scan can also be obtained to evaluate for a stress fracture.

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