Occurrence of a painful stress fracture of the femoral neck simultaneously with six other asymptomatic localizations in a runner

The authors report the case of 38-year-old man who suffered severe right groin pain after an unusually long run. Total body bone scan disclosed several hot spots in the lower limbs corresponding radiographically to stress fractures. Biological work-up did not reveal any significant abnormality. Hip, lumbar and forearm bone mineral densities were low compared to age- and sex-matched controls (Z-score ranging from -2 to -2.5). The occurrence of multiple stress fractures in a jogger has been favored by low bone mass and by excessive exercise. This case underlines that a lot of stress fractures can remain asymptomatic even when readily visible on plain radiographs