A 65-year-old woman with a history of osteoporosis slipped on a wet floor and is now unable to bear weight on her left leg due to severe hip pain. She presents with the left leg appearing shortened and externally rotated. What is the likely diagnosis and what are the next steps?
This presentation is highly suggestive of a hip fracture, likely a femoral neck fracture, given the patient's age, history of osteoporosis, mechanism of injury, and physical exam findings. The next step should be to obtain pelvic X-rays to confirm the diagnosis. If the initial X-ray does not show a fracture but the clinical suspicion remains high, an MRI should be ordered. This is a surgical emergency and requires orthopedic consultation.