Case 233

Medical History

A 73- year-old woman with a long-standing history of hypertension and osteoporosis, in chronic use of several unspecified medications, presents an unspecific pain in the left thigh for one month. She attends the emergency department after an episode of fall from her own height, complaining of severe pain in thigh. On examination, a shortening and lateral rotation of the left leg is observed. A plain radiograph of the proximal femur (image 1) was requested.


Image 1: Plain radiography of the proximal third of the left femur, anteroposterior view


Question:
Considering the radiographic image and the clinical data, select the most likely diagnosis and its risk factor:

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