An accurate diagnosis is mandatory to minimize increased comorbidity and mortality of delayed diagnosis with fast and efficient management of hip fractures also proven to be more cost effective. While most hip fractures are readily diagnosed using radiographs, which have an estimated sensitivity of between 90% and 98%, there is an equivocal or occult hip fracture group in which the clinical findings are suggestive of a fracture which is not confirmed by plain radiographs. It is estimated that as life expectancy rises around the world, the incidence of hip fractures may reach 6.3 million in 2050. With an ever-increasing elderly population, hip fracture is a major public health issue with an annual incidence of around 70,000–75,000 hip fractures per annum within the UK. ![]() MRI remains a valuable problem-solving tool in a select few cases following review with a musculoskeletal radiologist. Given the increased availability, improved patient tolerance and speed of CT imaging, we advocate its use as the main second-line imaging modality. Conclusion:ĬT and MRI are comparable at detecting occult femoral neck fractures. CT detected more non femoral pelvic fractures 47% versus 37%. The remaining 11 patients were either negative or MRI proved CT suspicions of fracture when extra diagnostic certainty was requested by the surgeons. About 13% of patients underwent MRI following CT and in 1/13 case MRI detected an occult fracture that had not been detected on CT. Results:Ībout 16% of patients undergoing CT as second-line test had proven originally occult femoral neck fractures on plain radiograph compared with 13% of those having MRI. All relevant imaging was reviewed and diagnosis, any third-line or follow-up imaging was documented. Using the radiology information system, a total of 168 patients were identified with the suspected occult neck of femur fractures over 24 months who had undergone CT or MRI as second-line investigation. ![]() The aim of this study was to compare computed tomography (CT) and magnetic resonance imaging (MRI) to ascertain the optimum second-line investigation in cases where plain radiograph is not diagnostic. There is an increasing incidence of hip fracture with associated morbidity and mortality making accurate and timely diagnosis essential.
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