Mother is Alzheimer s patient, mod-severe. S/p right hip fracture /implant 7 years ago. Approximately 7 days ago caregivers found her right buttock swollen 2-3 times normal size. Examination of buttock was firm with no apparent bruising or abrasion. Patient walked and sat with no pain. Motrin was given, mod. dose. Caregivers reported a slight decrease in swelling the next day. A slight discoloration was now seen, like bruised, still no complaints from the patient. Now, 7 days after, buttock still swollen with dark bruise coloration extending into right inner thigh area. Patient is complaining of hip pain with weight bearing. Could this be a fatigue fracture or complication of initial implant? Possibility of fall, however not observed. Mother is 87 years old but very mobile! Should she be taken to E.R. now or orth. surgeon? Thank you for your assessment.