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Femoral Cortical Thickening

I am a 22 year old, 6'2", 185lb, male who has grown up playing sports my whole life. I had two surgies on my left ankle for Osteochondritis dissecans at the end of high school which ended my sports career (the first one didn't work). I have just been trying to stay in shape since.

I've had upper right thigh pain for a year now on the inside of my femur. When I first started getting the pain the only activity I was doing was 4 mile runs twice a week. I ran on one of those elevated tracks that are slightly tilted and I went the same direction every time. My right leg was on the inside of the track so I think this may be what caused my injury. My leg would hurt, it seemed randomly (not right after running or during), for about a month or two. It got to the point where sometimes it would wake me up in the middle of the night it hurt so much. The pain would mostly be in my upper thigh but it could extend all the way down to my knee. I stopped running and went to an orthopedic doctor.

I had looked online to try and diagnose myself and found I had similar symptoms of an osteoid osteoma. So I got an x-ray and a CT scan. They showed a cortical thickening in my femur and the radiologist said there was no sign of an osteoid osteoma. He also told me my bones looked "unremarkable". I assume that is because he is looking at old people bones all day. My doctor didn't seem to know what to do about it. He just said I have a "stress injury". He could recreate the pain very easily when I'm lying on my back. I lift up my leg and have to resist him pushing it down. I have to give up after about 1 second as it is pretty painful.

I stopped all physical activity for about 5 months and it seemed to hurt a little less and less often. I also noticed I could get rid of the pain sometimes with ibuprofen which my doctor recommended to try. This makes me think my pain is due to inflammation. I started to get worried about muscle dystrophy, so I started to run 1 mile a couple times a week. My leg would hurt towards the end but I would ice it when I got home and it would be fine the next day.

This is the point where I am at now and it is just not getting better. I am at school year round and my insurance doesn't cover out of state so I can never go see another doctor. I just want to figure out what is wrong with it so I can find a way to fix it. My doctor described cortical thickening as my bone being a little thicker but how is that a bad thing?

Any help or suggestions would be greatly appreciated. And sorry for the book =/ Thanks!
1 Responses
1711789 tn?1361308007
Hi there!

Well, without a detailed clinical evaluation it would be difficult to determine the cause of your symptoms. Possibilities that may need to be considered include overexertion, muscle fatigue, injuries to muscles/ ligaments/ tendons, neuro-muscular causes such as neuropathies, myopathies, infections, inflammations, degeneration, micronutrient deficiencies, referred pain from other regions etc. Cortical thickening could occur with a few inflammatory causes may not be anything to worry about. I would suggest rest for a few days along with anti-inflammatory medications followed by physiotherapy. If the conservative management does not seem to help, you may consider a review with an orthopedician to evaluate for other possibilities and suggestion of an appropriate management plan.
Hope this is helpful.

Take care!
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