{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:10:26Z","timestamp":1756379426238,"version":"3.44.0"},"reference-count":8,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,4,11]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>A healthy man in his early 70s taking no regular medications presented to a tertiary hospital emergency department three times in 4\u2009weeks with the isolated symptom of moderate-to-severe non-traumatic unilateral distal right thigh pain on weightbearing. Plain radiographs of the femur and knee were performed on each occasion. Imaging reports of the first and second occasions made a comment of mild degenerative changes of the tibiofemoral joint with no other abnormalities, resulting in the patient being discharged with a diagnosis of knee osteoarthritis, provision of analgesia and advice to follow-up with his general practitioner. The third imaging report highlighted a subacute transverse diaphyseal femoral fracture that was subsequently confirmed using CT. Further investigations ruled out underlying pathological causes of the atraumatic fracture, and the fracture was managed conservatively. This case explores a femoral diaphyseal fatigue stress fracture in a patient with no intrinsic risk factors.<\/jats:p>","DOI":"10.1136\/bcr-2024-263103","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T09:55:15Z","timestamp":1745661315000},"page":"e263103","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Femoral diaphyseal fatigue stress fracture in an older adult male with normal bone mineral density"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7220-9051","authenticated-orcid":false,"given":"Hayden James","family":"Jackson-Cross","sequence":"first","affiliation":[{"name":"Geriatric Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivlal","family":"David","sequence":"additional","affiliation":[{"name":"Geriatric Medicine, Joondalup Health Campus, Joondalup, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"key":"2025082803425947000_18.4.e263103.1","doi-asserted-by":"crossref","DOI":"10.1177\/20420188211049619","article-title":"Current concept of stress fractures with an additional category of atypical fractures: a perspective review with representative images","volume":"12","author":"Oh","year":"2021","journal-title":"Ther Adv Endocrinol Metab"},{"key":"2025082803425947000_18.4.e263103.2","first-page":"525","article-title":"Stress Fractures: Concepts and Therapeutics","volume":"102","author":"Moreira","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"2025082803425947000_18.4.e263103.3","doi-asserted-by":"publisher","DOI":"10.1007\/s10140-016-1390-5"},{"key":"2025082803425947000_18.4.e263103.4","first-page":"39","article-title":"Stress fractures: diagnosis, treatment, and prevention","volume":"83","author":"Patel","year":"2011","journal-title":"Am Fam Physician"},{"key":"2025082803425947000_18.4.e263103.5","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1998"},{"key":"2025082803425947000_18.4.e263103.6","unstructured":"Therapeutic Guidelines . Osteoporosis and minimal-trauma fracture. Therapeutic Guidelines Limited; 2019. Available: https:\/\/tgldcdp.tg.org.au\/"},{"key":"2025082803425947000_18.4.e263103.7","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.1893"},{"key":"2025082803425947000_18.4.e263103.8","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12877-020-1412-8","article-title":"Pain and recurrent falls in the older and oldest-old non-institutionalized population","volume":"20","author":"G\u00e1lvez-Barr\u00f3n","year":"2020","journal-title":"BMC Geriatr"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:43:11Z","timestamp":1756377791000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":8,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,26]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2024-263103"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263103","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}