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This is an individual from Westness, Orkney who has posttraumatic osteolysis of the femoral neck.  In this case osteolysis could have been initiated by a traumatic event or abnormal stress resulting in fracture of the neck.  The rate of absorption of the neck is rapid and has been found to take as little as 23 days. The femoral head may remain intact the acetabulum, but it becomes devascularised (Lambiase et al. 1999).

Right femur

The femoral neck is absent, with no indication of infection.  There is a continuous cortical surface over the neck region from the anterior to the posterior margins.  The trochanteric fossa is enlarged.  Little evidence remains for new bone formation; however, inferior to the trochanteric fossa is a large ovoid post-mortem depression that precludes observations of bony changes in this area.  There is a large shallow depression–likely caused by stress on the musculature and ligamanets–that is located at the intertrochanteric line and extending inferiolaterally.  There is an enlargement of the anterior portion of the greater tubercle and enthesopytes adjacent to the lesser tubercle.

Surrounding the fovea is a large area of bone destruction and exposure of the trabeculae with new irregular compact bone along the margin.  This does not have the appearance of avascular necrosis.   Along the inferior margin is an area of osteophytosis.  There is post-mortem damage to the lateral portion of the femoral head and, therefore, it is not known what bony changes would have occurred in response to the osteolysis of the neck.

Lambiase, R.E., Levine, S.M., Froelich, J.A, 1999. Rapid osteolysis of the femoral neck after fracture. American Journal Roentgenology, 172: 489-491

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