Atypical femoral fracture — SCE Rheumatology MCQ
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Correct answer: C — Image both full femora, using MRI for an uncertain incomplete lesion
Explanation lettering: D = shown as A · C = shown as B · A = shown as C · B = shown as D
A is correct. Atypical femoral fractures are frequently bilateral, so both full femora should be assessed even when symptoms are unilateral. MRI or isotope imaging can clarify an occult or incomplete lesion. B misses contralateral disease. C cannot localise a femoral cortical crack. D delays assessment and permits propagation. E provides systemic turnover information, not fracture anatomy.
Reference: NOGG: strategies for osteoporosis and fracture-risk management: https://www.nogg.org.uk/full-guideline/section-7-strategies-management-osteoporosis-and-fracture-risk