X-ray of hip fractures
Even if there's an initial obvious fracture, evaluate:
- Bone contours for disruptions
- Bone areas for unusual lines that are either hypoattenuating (in case of separation) or hyperattenuating (in case of compression)
Also have a glance at the projected pelvic bones.
If findings are equivocal of a fracture, or there is a strong clinical suspicion despite a normal X-ray, further imaging can be done with CT and/or MRI:
- Case 1
Continued from X-ray above:
CT scan confirms the diagnosis, in this case as a radiolucent line.
- Further information: X-ray of the hip#Prostheses and other orthopedic fixations
- Case 2
Subsequent CT scan of the same case as above. The cortex is coherent, which is atypical of a fracture.
Subsequent T1-weighted turbo spin echo MRI confirms a fracture, as the surrounding bone marrow has low signal from edema.
In AO classification, these fractures are classified as either nondisplaced or displaced (not necessarily including how much).
Trochanteric fractures are subdivided into either intertrochanteric (between the greater and lesser trochanter) or pertrochanteric (through the trochanters) by the Müller AO Classification of fractures. Practically, the difference between these types is minor. The terms are often used synonymously. An isolated trochanteric fracture involves one of the trochanters without going through the anatomical axis of the femur, and may occur in young individuals due to forceful muscle contraction. Yet, an isolated trochanteric fracture may not be regarded as a true hip fracture because it is not cross-sectional.
|Types of fracture misalignment:
- For a full list of contributors, see article Radlines:Authorship for details. . Creators of images are attributed at the image description pages, seen by clicking on the images. See
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