Clinical indications: "Acute on chronic pain of several weeks duration. Non weight-bearing." What information would you include in your report? What are your recommendations and how might they affect treatment?
"Transverse fracture of the middle third of the right femoral diaphysis with medial beaking. In the absence of appropriate trauma, atypical femoral fracture is likely and radiographs of the contralateral femur are recommended to assess for incomplete fractures." Telephone the caring team to arrange orthogonal radiographs of the entire left femur, as bilateral atypical fractures are common and occur anywhere from the lesser trochanter to the supracondylar flare. (Communication, collaboration, patient advocacy.) Ask if the patient is taking bisphosphonates. If so, therapy should be ceased as they increase the likelihood of atypical femoral fracture 50-fold and this recommendation can be included in the report. (Communication, collaboration.) The patient may need reassurance and an explanation of why the opposite limb needs evaluation. (Communication, compassion.) Explain to the radiographer what views are required. (Communication.)
Complete fracture of the mid proximal femoral shaft with a transverse orientation of the fracture line medial "beaking". Distal rotation and displacement.