A 78 year old woman presents with right groin pain which has been present for 3 days. Three days ago she slipped on a throw rug. However she managed to catch herself and did not fall to the ground. Since that time, however, she has noted groin pain and has been limping slightly. She has a history of vertebral compression fracture three years ago after a fall in the bathroom.
Physical exam reveals a frail, elderly woman who is limping with a lurch over the right side.
She has a positive Trendelenberg sign on the right. Range of motion of her hips is symmetrical. However, the patient guards and has slight pain with medial rotation of her right hip. X-rays reveal a dense line across the femoral neck.