![]() ![]() The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). This is particularly important when the recommended agent is a new and/or infrequently employed drug. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. Usage and distribution for commercial purposes requires written permission. ![]() doi: 10.1016/j.injury.2016.02.This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Imaging of occult hip fractures: CT or MRI? Injury. Rehman H, Clement RG, Perks F, White TO.For those who are cognitively functioning, total hip arthroplasty appears to be the best option. Verbeeten KM, Hermann KL, Hasselqvist M, et al.The advantages of MRI in the detection of occult hip fractures. For displaced femoral neck fractures in the elderly, cognitive function should be determined.Sensitivity and specificity of CT- and MRI-scanning in evaluation of occult fracture of the proximal femur. Haubro M, Stougaard C, Torfing T, Overgaard S.In cases of badly displaced femoral neck fractures, the decreased blood. Br J Radiol. 2016 89(1060):20150250.doi: 10.1259/bjr.20150250 These fractures may disrupt the blood supply to the fractured portion of the bone. The validity of investigating occult hip fractures using multidetector CT. Thomas RW, Williams HL, Carpenter EC, Lyons K.Prevalence of traumatic hip and pelvic fractures in patients with suspected hip fracture and negative initial standard radiographs – a study of emergency department patients. Dominguez S, Liu P, Roberts C, Mandell M, Richman PB.Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly. Karagas MR, Lu-Yao GL, Barrett JA, Beach ML, Baron, JA.Shenton’s line, hip fracture, transcervical fracture, subcapital fracture, pelvis CT, hip x-ray, trauma, comminuted fracture, impacted fracture, femoral neck fracture, orthopedics. Plain film radiographs have been found to be at least 90% sensitive for hip fractures CT’s have been found to be 87%-100% sensitive and 100% specific for occult hip fractures in which plain radiographs were read as negative, but the patient still complained of hip pain Although MRI is currently the gold standard for detecting occult hip fractures (sensitivity and specificity = 100%), given MRI’s limited accessibility in the ED as well as the high sensitivity and specificity of CT scans for occult hip fractures, it is generally recommended to obtain CT scans for patients with suspected occult hip fractures as a first-line investigation Topics: 1 Diagnosing a femoral neck fracture can be made with plain x-ray, CT, or MRI. Discussion:įemoral neck fractures are one of the most common types of hip fractures, accounting for 49.4% of all hip fractures. The neck of the femur is displaced superiorly relative to the head of the femur while the head of the femur remains in its anatomical position within the acetabulum. This correlates with findings seen on pelvic CT, which reveals both a subcapital fracture (blue arrow) and transcervical fracture (yellow arrow). In the anteroposterior view bilateral hip x-ray, there is an evident loss of Shenton’s line on the left (red line) when compared to the normal right (white line), indicative of a fracture in the left femoral neck. Left hip X-ray and pelvic CT revealed comminuted, impacted transcervical and subcapital fracture of the left femoral neck. Subcapital Neck of Femur Fractures fracture distal to articular surface & proximal to intertrochanteric region 4ys younger than Intertrochanteric Fracture 1. Sensation and pulses were intact in bilateral lower extremities. Exam showed left hip tenderness, 3/5 left lower extremity strength secondary to pain, and 5/5 right lower extremity strength. Pain is 3/10 in severity and exacerbated by movement. A 74-year-old male presented to the emergency department with left hip pain after falling off his bicycle. ![]()
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