“…Such subclinical deficiency will commonly progress silently, without obvious clinical manifestations, until it is suddenly revealed when a spontaneous fracture occurs. The literature suggests that patients usually complain of bilateral groin or thigh pain that persists over a period of a few weeks to several months [[23], [24], [25], [26], [27], [28], [29]], so that these fractures develop gradually and diagnosis is typically delayed. In cases such as this, even if the initial radiographs are negative, the possibility of bilateral hip fracture should be considered, particularly if the pain worsens suddenly or the patient exhibits signs of bone insufficiency [26].…”