Radiology Quiz

This 65 year old farmer complained of increasing pain and stiffness in his right hip on walking, with the pain now interfering with his sleep. His wife also mentioned that he now seems to limp on the right hand side. He also complained of restricted movement in the right leg that was confirmed on examination of the hip.

Questions

(1) What abnormalities does this radiograph show?
(2) What further questions would you like to ask or what examinations would you like to do?
(3) Indicate exactly where you would find the specific radiograph changes characteristic of this disease
(4) What is your exact diagnosis?
(5) Give the potential causes of this disease.

See the answers.

Barry Kelly, consultant radiologist, Royal Victoria Hospital, Belfast

Ian C Bickle, fourth year medical student, Queen's University, Belfast

We would like to thank James Nixon, professor of orthopaedic surgery, Musgrave Park Hospital, Belfast, for his help.

studentBMJ 2000;08:435-476 December ISSN 0966-6494