Femur Stress Fracture

hi Sue. You might consider the progression of the possible hairline fracture. X ray doesn't rule out hairline fracture and doesn't offer consolatory soft tissue causes. Given the complexity of the situation with the medication choices and the hip replacement, x ray could be an unfortunate waste of time. Delayed treatment of a hairline fracture can result in a complete break and, in this situation , damage to the hip replacement.

@gently Been there! My ortho started with the x-ray, saying Medicare wouldn't cover further imaging without it. The MRI still didn't show anything either - even in soft tissue - it turned out to be bursitis.

And after 20 very active years with hip implants and revisions, as well as necrosis from heavy metal poisoning, I have learned I am a lot more durable than I used to think!

Will be facing the same with my spine in 2 days after a hard fall and worsening pain - the x-ray even precedes the consultation.

We could continue to discuss this, but standard triage begins with the x-ray.
https://www.hopkinsmedicine.org/imaging/provider-information/order-wisely/acute-hip-pain

Thankfully we can share information on this site; don't know how I'd handle osteoporosis diagnosis, drug therapy, nutrition, exercise what to do and what to avoid, supplements, any other odd/concerning/questionable symptoms etc. Just don't get the info from the doc. Impossible in a 15 minute once a year appointment. Just fear that something awful is happening (fracture! while on meds to avoid fracture?? then what's the purpose of meds? maybe best-case scenario is to not get worse) or any side effects that will truly change life (very rare but also very worrisome). At any rate, pain is almost gone so feeling foolish! BUT serious side effects do happen; one year of Fosamax with bone pain; one year of Reclast with bone pain so constant worry!

@jozer We've all been here "At any rate, pain is almost gone so feeling foolish! " I would probably go ahead and see the doc, just in case.

Chronic health issues can be a real trial - I seem to need a new specialist every year - talking to others on Mayo Connect keeps me sane.

@sueinmn mri on the hip does not work for us as we have replaced hip parts and the metal interferes. I would start with an x-ray followed by a CAT scan. If you have a hairline fracture, it won’t show up on an x-ray for about two weeks until it actually begins to heal. I fractured metatarsal bone in my foot and that was the same situation. Had to wait 10 to 14 days before it would show on x-ray

@willowmena While early hip and knee implants may have had components made of ferrous metals which could not withstand an MRI, modern implants, in the past 20+ years, are typically made of titanium, chromium, cobalt, ceramic and polymers, which are safe. Certain settings may need to be adjusted to get an accurate image, so be sure the ordering doctor and the MRI tech know exactly where you have implants.

The surgeon who installed my hip is the one sending me for the MRI, because the x-ray did not provide the image he needs. I have had other MRI's done safely and effectively over the years, and I have metal parts all over my body. Before the test, the imaging center always calls and asks about these.
Did someone tell you that you could not have an MRI after a hip replacement?

@sueinmn it’s not a safety issue, but rather they cannot get a good image because the metal blocks it

@willowmena I asked theMRI technician today and his response was "Good question. The machine takes thousands of images and stitches them together. Special software is used to resolve any distortions. The radiologist knows how to interpret the results surrounding any obstruction." He went on to confirm what I knew - the MRI was ordered specifically to review damage to other nearby bones and tissues, not the hip itself. But he did say that if there was a femur fracture the enhanced MRI would reveal it in spite of the hardware.

I trust my ortho physician to order appropriate tests as necessary - I chose him for his expertise. So far in 15 years, my trust in him has not been wrong.