What is the primary condition that must be ruled out when evaluating a young athlete with amenorrhea and hip pain?

• A. Osteoarthritis
• B. Septic arthritis
• C. Femoral neck fracture
• D. Labral tear

Answer: (C)

The primary condition that needs to be ruled out when evaluating a young athlete presenting with amenorrhea and hip pain is a femoral neck fracture. In young athletes, especially those involved in high-impact sports, a femoral neck fracture can occur due to stress or trauma, and it often presents alongside hip pain. The presence of amenorrhea raises concern for potential underlying issues such as the female athlete triad, which includes disordered eating, amenorrhea, and osteoporosis, making stress fractures more likely.

Femoral neck fractures can lead to significant complications if not diagnosed and treated promptly. The symptoms may overlap with other hip conditions, but the potential for serious injury makes it imperative that this condition be assessed thoroughly. This includes evaluating for signs of fracture, such as point tenderness, limited range of motion, and habitual loading patterns that might have led to the injury.

While septic arthritis can also present with hip pain, it is usually accompanied by systemic symptoms such as fever and an acute presentation of joint swelling. Labral tears may lead to hip pain but are less immediately life-threatening compared to a fracture. Osteoarthritis is less common in this age group and would not typically coexist with amenorrhea. Thus, ruling out a femoral neck fracture is critical in