Heroin induced osteopenia: a cause of bilateral insufficiency femoral neck fracture in a young adult

Stress fractures of the femoral neck are potentially disabling injuries if the diagnosis is missed or delayed and proper treatment is not provided. We report the first in the literature bilateral femoral neck insufficiency fracture in a young female, due to heroin and methadone use related osteoporosis. A high index of clinical suspicion and prompt imaging in the case of activity related hip pain could prevent missing such pathology in this cohort of patients, avoiding its devastating sequelae.