A 65 year old female is brought into the ER by her husband. Early in the morning

Question

A 65 year old female is brought into the ER by her husband. Early in the morning she fell while getting out of the shower. In the ER she complains of pain in her right hip and right wrist. She is an active woman healthy and has no documented medical illnesses. She does not take any vitamins or supplements and she denies any history of hormone replacement therapy. She became postmenopausal at the age of 38. She is thin five one in height and weighs 100 pounds.
1) what is the most likely clinical diagnosis?
2)what is the etiology/pathologenesis of this condition?
3)what are the risk factors associated with this condition?
4)list the clinical presentations.
5)list the imaging modalities that may assist you in diagnosing and treating this condition.
6)what treatments are currently available to treat or minimize the effects of this condition?

Explanation / Answer

she is 65 year old ..considered as post menopausal women. considering her geriatric age ...history of sudden fall could be cause of suspecious of fracture of hip and wrist. so this is one the reason for pain.

probable clinical diagnosis is fracture of hip or wrist

severe force of trauma due to sudden fall or slip .so this unexpected trauma may cause fracture of stress bearing bones like hip .

risk factors like age >60, osteoporosis ( common in post menupausal women

clnical features : severe pain, inability to move hip or wrist, swelling or bruising, unable to stand normally

imaging modalities like plani film radiography ..AP view , lateral view of hip/wrist, best view is internal rotation gives best view for femoral neck fracture.

best confirmatory imaging is MRI than CT

regional analgesia is for pain controle and arthroplasty for displaced hip fractures, with orthopaedic consultation appropriate managment shouldbe given. direct wire fixation or rigid fixation are treatment modalities

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