Imaging of occult hip fractures: CT or MRI? |
| |
| Institution: | 1. Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, Scotland;2. Royal Infirmary of Edinburgh, Little France, Edinburgh EH16 4SA, Scotland;1. AO Research Institute Davos, Davos Platz, Switzerland;2. Medical Faculty, Albert Ludwigs University of Freiburg, Freiburg, Germany;1. Department for Plastic Surgery, Hand Surgery and Reconstructive Microsurgery, BG Trauma Center Murnau am Staffelsee, Germany;2. Department for Plastic Surgery and Hand Surgery, Klinikum rechts der Isar, Technische Universität München, Germany;1. Department of Orthopaedic Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China;2. College of Surveying and Geo-Informatics, Tongji University, China;3. Yang Zhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai, China;4. Department of Orthopaedic Surgery, the First Rehabilitation Hospital of Shanghai, China;1. Specialty Registrar in Trauma and Orthopaedic Surgery Queen''s Medical Centre, United Kingdom;2. Specialty Registrar in Trauma and Orthopaedic Surgery Queen''s Medical Centre, United Kingdom;3. Orthopaedic Trauma Surgeon Queen''s Medical Centre, United Kingdom;4. Orthopaedic Trauma Surgeon Queen''s Medical Centre, United Kingdom;1. Nepean Hospital, Sydney, Australia;2. Northern Hospital, Melbourne, Australia;3. University Hospital Geelong and School of Medicine, Deakin University, Geelong, Australia;4. Department of Surgery, University of Melbourne, Epworth Hospital, Melbourne, Australia;5. Department of Orthopaedics, The Alfred Hospital, Melbourne, Australia |
| |
| Abstract: | ObjectivesPatients presenting with hip pain but normal plain radiographs may ultimately be shown on further investigation to have suffered an occult hip fracture (OHF). This diagnosis can be made with CT or MRI. Traditionally MRI has been considered a superior modality. We performed a retrospective review of all patients presenting to our service with a suspected OHF over a four-year period, investigated with either CT or MRI.DesignRetrospective review.SettingUrban trauma centre.PatientsPatients with suspected hip fractures and negative radiographs.InterventionCT or MRI.Main outcome measuresDetection rate; delay in request for further imaging; delay to theatre; re-presentations with missed fractures.ResultsA total of 179 patients were investigated, with a mean age of 82 ± 13 years. The ultimate diagnosis was of an OHF in 71 cases and pelvic or acetabular fracture in 34. The average time from presentation plain radiograph to further imaging was 2.0 ± 2.7 days, but was significantly shorter for CT. No patient re-presented with unidentified fractures or other localised hip pathology within a 12-month period.ConclusionsModern imaging technology does not appear to miss clinically significant fractures. As CT is usually more accessible than MRI, the results of our study should encourage surgeons to consider CT as a first line investigation for occult hip fractures. We advocate a high index of suspicion and early imaging referral for elderly patients presenting with non-specific hip pain following a fall.Level 3 Evidence. |
| |
| Keywords: | CT MRI Occult hip fractures |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
