English: A 74-year-old Nigerian woman was referred to our surgical outpatients department from the Radiotherapy Department in September 2007 with a 5-month history of pain in both hips and a 4-month history of inability to walk. The pain had started in the right hip and involved the left hip about a month later. The pain was insidious and was associated with a worsening limp, which required her to walk with the aid of a walking stick. She had been bedridden for about 4 months before presentation but she had no history of falls.

She had been diagnosed with a stage 1b invasive squamous cell carcinoma of the cervix 2 years before presentation and was treated primarily with 45Gy of external radiation therapy for 42 days in fractionated doses and had been symptom-free thereafter. A pelvic radiograph showed subcapital fractures of both femurs, with osteonecrosis of the heads.

Figure: Pelvic radiograph after bilateral hip hemiarthroplasty