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Hip fracture — USMLE Step 2 CK MCQ

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ModerateSurgeryHip fractureUSMLE Step 2 CK

A 68-year-old African American man comes to the clinic because of progressive symptoms. History and focused examination are notable for older adult with externally rotated shortened leg after a fall. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and imaging support an acute surgical process without suggesting a safer outpatient approach. Which of the following is the most likely diagnosis?

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Correct answer: D — Hip fracture

The vignette describes Hip fracture, supported by older adult with externally rotated shortened leg after a fall. Hip fracture is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: AAOS 2021 Hip Fracture Guideline