Difference between revisions of "X-ray of hip fractures"
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| − | '''Hip fractures''' are fractures of the proximal femur. | + | |
| + | '''Hip fractures''' are [[fractures]] of the [[proximal femur]]. | ||
==Detection== | ==Detection== | ||
| − | [[File:X-ray of | + | [[File:X-ray of mildly compressed hip fracture, annotated.jpg|thumb|[[Projectional radiography|X-ray]] shows a suspected mildly compressed hip fracture, as incongruity of the cortex.]] |
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===Further imaging=== | ===Further imaging=== | ||
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: | 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: | ||
| − | <gallery> | + | |
| + | ;Case 1: | ||
| + | Continued from X-ray above: | ||
| + | <gallery mode=packed heights=170> | ||
| + | File:CT of mildly compressed hip fracture, annotated.png|[[CT scan]] confirms the diagnosis, in this case as a radiolucent line. | ||
| + | File:X-ray of Hansson pins for mildly compressed hip fracture.jpg|The patient was treated with Hansson pins. | ||
| + | </gallery> | ||
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| + | {{Further|X-ray of the hip#Prostheses and other orthopedic fixations}} | ||
| + | |||
| + | ;Case 2: | ||
| + | <gallery mode=packed heights=170> | ||
| + | File:X-ray of subtle compressive hip fracture.jpg|thumb|In this case, a hip fracture appearing as a subtle subcapital radiodense line. | ||
File:CT of subtle compressive hip fracture.jpg|Subsequent [[CT scan]] of the same case as above. The cortex is coherent, which is atypical of a fracture. | File:CT of subtle compressive hip fracture.jpg|Subsequent [[CT scan]] of the same case as above. The cortex is coherent, which is atypical of a fracture. | ||
File:T1 TSE MRI of hip fracture.jpg|Subsequent T1-weighted turbo spin echo [[MRI]] confirms a fracture, as the surrounding bone marrow has low signal from edema. | File:T1 TSE MRI of hip fracture.jpg|Subsequent T1-weighted turbo spin echo [[MRI]] confirms a fracture, as the surrounding bone marrow has low signal from edema. | ||
Latest revision as of 16:21, 29 January 2019
Author:
Mikael Häggström [notes 1]
Hip fractures are fractures of the proximal femur.
Contents
Detection
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.
Further imaging
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.
The patient was treated with Hansson pins.
- Further information: X-ray of the hip#Prostheses and other orthopedic fixations
- Case 2
In this case, a hip fracture appearing as a subtle subcapital radiodense line.
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.
Classification
Subcapital
In AO classification, these fractures are classified as either nondisplaced or displaced (not necessarily including how much).[1]
Trochanteric
Trochanteric fractures are subdivided into either intertrochanteric (between the greater and lesser trochanter[2]) or pertrochanteric (through the trochanters[2][3]) by the Müller AO Classification of fractures.[4] Practically, the difference between these types is minor. The terms are often used synonymously.[5][6] 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.[7] Yet, an isolated trochanteric fracture may not be regarded as a true hip fracture because it is not cross-sectional.
Misalignment
Types of fracture misalignment:[8]
|
Reporting
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ . Revised AO/OTA classification (Jan 2018) - Proximal femur. Retrieved on 2018-06-19.
- ↑ 2.0 2.1 Page 245 in: David J. Dandy, Dennis J. Edwards (2009). Essential Orthopaedics and Trauma, 5th edition . Elsevier Health Sciences. ISBN 9780702042096.
- ↑ Schipper, Inger B.; Steyerberg, Ewout W.; Castelein, Rene M.; Vugt, Arie B. van (2009). "Reliability of the AO/ASIF classification for pertrochanteric femoral fractures ". Acta Orthopaedica Scandinavica 72 (1): 36–41. doi:.
- ↑ Ernst Raaymakers, Inger Schipper, Rogier Simmermacher, Chris van der Werken. Proximal femur. AO Foundation. Archived from the original on 24 April 2017. Retrieved on 2017-04-23.
- ↑ Page 190 in: Richard A. Gosselin, David A. Spiegel, Michelle Foltz (2014). Global Orthopedics: Caring for Musculoskeletal Conditions and Injuries in Austere Settings . Springer Science & Business. ISBN 9781461415787.
- ↑ Page 365 in: Anita K. Simonds (2007). Non-Invasive Respiratory Support, Third edition: A Practical Handbook . CRC Press. ISBN 9780340809846.
- ↑ Page 303 in: Thomas Pope, Hans L. Bloem, Javier Beltran, William B. Morrison, David John Wilson (2014). Musculoskeletal Imaging E-Book (2 ed.). Elsevier Health Sciences. ISBN 9780323278188.
- ↑ . Introduction to Trauma X-ray. Radiology Masterclass. Retrieved on 2018-07-03.
