Misdiagnosis of Greater Trochanteric Fracture in a Young Adult: A Case Report

Abstract

Background: Misdiagnosis remains a major clinical challenge, even when patients are initially assessed by multiple healthcare providers. Musculoskeletal injuries, particularly hip trauma, require rigorous screening, careful differential diagnosis, and the use of appropriate imaging. Case Presentation: A 26-year-old Bahraini male developed acute left hip pain following a fall from a horse. Initial emergency department evaluation, including plain radiographs, did not reveal a fracture, and he was treated conservatively with analgesics and NSAIDs. Despite repeated consultations, his pain persisted, and he was referred to physiotherapy with a provisional diagnosis of “hip pain.” During physiotherapy assessment, several red flags were identified, including a traumatic mechanism of injury, persistent pain, limping gait, and lack of improvement with prior management. Further imaging confirmed a fracture of the greater trochanter fracture.
Discussion: Greater trochanteric fractures are rare and frequently overlooked on plain radiographs. MRI is considered the gold standard for detecting occult hip fractures. Early recognition is essential, as inappropriate treatment—such as physiotherapy under a misdiagnosed label—may result in fracture displacement, prolonged disability, or surgical intervention. Conclusion: This case highlights the importance of independent diagnostic evaluation, even when patients arrive with prior referrals. Comprehensive screening and timely imaging (if needed) are critical to avoid misdiagnosis and ensure optimal patient outcomes.