Are occult fractures of the hip and pelvic ring mutually exclusive?

Lakshmanan, Palaniappan; Sharma, Ankur; Lyons, K.; Peehal, Jeetender Pal

doi:10.1302/0301-620x.89b10.19539

Cited by 19 publications

(9 citation statements)

References 11 publications

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“…There were, however, no patients with fractures of the femoral neck who had associated fractures of the pelvic ring. These findings agree with those of Lakshmanan et al, 17 in that they seem to be mutually exclusive. Consequently, we do not recommend an MR scan in the presence of an acute fracture of the pubic ramus on plain radiographs.…”

Section: Discussionsupporting

confidence: 93%

The use of MRI to detect occult fractures of the proximal femur

Sankey

Turner

Lee

et al. 2009

The Journal of Bone and Joint Surgery. British volume

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An MR scan was performed on all patients who presented to our hospital with a clinical diagnosis of a fracture of the proximal femur, but who had no abnormality on plain radiographs. This was a prospective study of 102 consecutive patients over a ten-year period. There were 98 patients who fulfilled our inclusion criteria, of whom 75 were scanned within 48 hours of admission, with an overall mean time between admission and scanning of 2.4 days (0 to 10). A total of 81 patients (83%) had abnormalities detected on MRI; 23 (23%) required operative management. The use of MRI led to the early diagnosis and treatment of occult hip pathology. We recommend that incomplete intertrochanteric fractures are managed non-operatively with protected weight-bearing. The study illustrates the high incidence of fractures which are not apparent on plain radiographs, and shows that MRI is useful when diagnosing other pathology such as malignancy, which may not be apparent on plain films.

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Section: Discussionsupporting

confidence: 93%

The use of MRI to detect occult fractures of the proximal femur

Sankey

Turner

Lee

et al. 2009

The Journal of Bone and Joint Surgery. British volume

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“…In addition to hip fracture, CT demonstrated also other fractures such as obturator ring [26][27][28] acetabular, and sacral fractures, and although CT has less soft tissue contrast resolution than MRI, soft tissue injuries such as hematomas and hemorrhages [5] can be detected also with CT (Fig. 3) and explain pain without femur fracture.…”

Section: Discussionmentioning

confidence: 99%

High clinical utility of computed tomography compared to radiography in elderly patients with occult hip fracture after low-energy trauma

et al. 2011

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To evaluate the clinical utility of computed tomography (CT) compared to radiography in evaluating suspect or missed hip fractures in elderly after low-energy trauma. One hundred ninety-three hip CT examinations performed in two trauma centers during 3 years of evaluation of clinically suspect or occult hip fracture within 24 h of negative or suspect radiography were retrospectively reviewed. Consensus CT diagnosis by three observers was compared to clinical outcome and in some cases also further imaging. All patients were elderly and had sustained a low-energy trauma. Eighty-four examinations revealed no fracture. Follow-up was uneventful but for two patients who had been operated. Thirty-nine of 41 cervical hip fractures were surgically or otherwise confirmed, two cases were not operated due to week-old trauma and moderate symptoms. Twenty-nine of 68 trochanteric fractures or avulsions were confirmed surgically. Computed tomography has a high clinical utility as it can detect nearly all clinically suspect but radiographically negative cervical hip fractures as well as most trochanteric fractures and avulsions. A negative CT is near-perfect in ruling out a hip fracture requiring surgery.

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“…Beraberinde ön çap-raz bağ yırtığı olabileceği akılda tutulmalıdır. [20] 3. Patella kırığı: Direkt travma sonucu oluşabilen bu kırıkların tanısı yan grafi ile kolayca konulabilir.…”

Section: Segond Kırığıunclassified

Frequently seen incorrect or missing interpretations in orthopedic radiology: what do we need to see? what we cannot see?

Aygün¹

2013

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Are occult fractures of the hip and pelvic ring mutually exclusive?

Cited by 19 publications

References 11 publications

The use of MRI to detect occult fractures of the proximal femur

The use of MRI to detect occult fractures of the proximal femur

High clinical utility of computed tomography compared to radiography in elderly patients with occult hip fracture after low-energy trauma

Frequently seen incorrect or missing interpretations in orthopedic radiology: what do we need to see? what we cannot see?

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