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Acta Orthop. 2005 Aug;76(4):524-30.

MRI diagnosis of occult hip fractures.

Author information

  • 1Orthopedic Center, Musculoskeletal Division, UllevĂ„l University Hospital, Oslo, Norway. frede.frihagen@uus.no

Abstract

BACKGROUND:

Most fractures of the proximal femur are easily diagnosed by conventional radiography. When the images are judged to be negative or equivocal and a clinical suspicion of fracture persists, another approach is to use magnetic resonance imaging (MRI) to help reach a diagnosis.

METHODS:

In a prospective study running from November 1998 to December 2001, we registered all patients being examined by MRI who had had a negative or equivocal radiograph and where there was continued clinical suspicion of hip fracture.

RESULTS:

100 consecutive patients (67 women) were included, with an average age of 80 (37-100) years. The MRI examinations corresponded to 4% of the 2,350 patients admitted with hip trauma during the study period. 46 patients had a femoral neck or intertrochanteric fracture on MRI. 27 patients had other fractures. 18 had other findings on MRI, and 10 were interpreted as being negative, although one of these was a false negative. In a separate interobserver analysis, two experienced radiologists agreed on the diagnoses in 19/23 cases (kappa value 0.78). They agreed with a less experienced radiologist in 17/23 and 19/23 cases, respectively (kappa values 0.66 and 0.76).

INTERPRETATION:

MRI is a useful tool for demonstration of occult hip fractures. In the absence of a hip fracture, another explanation for the patient's pain and disability will often be given.

PMID:
16195069
[PubMed - indexed for MEDLINE]
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