Femoral neck stress fractures
in young healthy individuals are rare and occur in those who take part in
physical training with repetitive loading and those with osteoporosis. Bone
density is related to sex hormone status, which is artificially manipulated
during gender reassignment. Conflicting evidence currently exists on the effect
of cross sex hormone treatment on bone density, with no literature suggesting a
link between hormone treatment in gender reassignment and stress fractures.
Our
aim is to highlight the potential risk of stress fractures amongst transsexual
patients receiving cross sex hormones as part of gender reassignment. The
patient presented with groin pain after competing in a running event. Despite a
number of risk factors, there was a delay in diagnosis, which could have led to
complications compromising outcome.
Femoral neck stress fractures should be
considered in the differential diagnosis of transsexual patients receiving
hormone treatment with non-specific groin/thigh pain following exercise.
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By:
- 1Department of Trauma and Orthopaedics, Warrington and Halton Hospitals NHS Foundation Trust, Warrington, Cheshire, UK.
- BMJ Case Rep. 2016 Mar 31;2016. pii: bcr2015214110. doi: 10.1136/bcr-2015-214110.
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