Radiographic image of a broken Shenton’s curve, which shows the relationship of the femoral head to the acetabulum, indicates a femoral neck fracture. Your doctor may also perform other imaging tests such as the magnetic resonance imaging (MRI), and computer tomography (CT) scan to obtain further information. Your doctor will order an X-ray to diagnose a femoral neck fracture. Increased pain in the hip during rotation of the legįemoral neck fractures are diagnosed based on physical examination, your symptoms and circumstances of the accident.Shortening or sideways rotation of the affected leg.The symptoms of a femoral neck fracture include: Younger individuals unaccustomed to sudden strenuous activity or change in activity.High-impact trauma such as motor vehicle accidents.A minor fall or twisting of the hip in the elderly.In cases of badly displaced femoral neck fractures, the decreased blood supply prevents these fractures from healing. These fractures may disrupt the blood supply to the fractured portion of the bone. Femoral neck fractures may be either displaced, where the bone is moved out of its original position, or non-displaced, where there is no instability of the bone. The neck of the femur is the region just below the ball of the hip joint.įractures to the femoral neck can completely or partially disconnect the femoral head from the rest of the femur. doi: 10.1016/j.injury.2016.02.The hip is a ball-and-socket joint made up of the head of the thigh bone or femur that acts as the ball and fits into the rounded socket of the hip bone or acetabulum. Imaging of occult hip fractures: CT or MRI? Injury. Rehman H, Clement RG, Perks F, White TO.Verbeeten KM, Hermann KL, Hasselqvist M, et al.The advantages of MRI in the detection of occult hip fractures.Sensitivity and specificity of CT- and MRI-scanning in evaluation of occult fracture of the proximal femur. Haubro M, Stougaard C, Torfing T, Overgaard S. The validity of investigating occult hip fractures using multidetector CT. Thomas RW, Williams HL, Carpenter EC, Lyons K.Prevalence of traumatic hip and pelvic fractures in patients with suspected hip fracture and negative initial standard radiographs – a study of emergency department patients. Dominguez S, Liu P, Roberts C, Mandell M, Richman PB.Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly. Karagas MR, Lu-Yao GL, Barrett JA, Beach ML, Baron, JA.Shenton’s line, hip fracture, transcervical fracture, subcapital fracture, pelvis CT, hip x-ray, trauma, comminuted fracture, impacted fracture, femoral neck fracture, orthopedics. Plain film radiographs have been found to be at least 90% sensitive for hip fractures CT’s have been found to be 87%-100% sensitive and 100% specific for occult hip fractures in which plain radiographs were read as negative, but the patient still complained of hip pain Although MRI is currently the gold standard for detecting occult hip fractures (sensitivity and specificity = 100%), given MRI’s limited accessibility in the ED as well as the high sensitivity and specificity of CT scans for occult hip fractures, it is generally recommended to obtain CT scans for patients with suspected occult hip fractures as a first-line investigation Topics: 1 Diagnosing a femoral neck fracture can be made with plain x-ray, CT, or MRI. Discussion:įemoral neck fractures are one of the most common types of hip fractures, accounting for 49.4% of all hip fractures. The neck of the femur is displaced superiorly relative to the head of the femur while the head of the femur remains in its anatomical position within the acetabulum. This correlates with findings seen on pelvic CT, which reveals both a subcapital fracture (blue arrow) and transcervical fracture (yellow arrow). In the anteroposterior view bilateral hip x-ray, there is an evident loss of Shenton’s line on the left (red line) when compared to the normal right (white line), indicative of a fracture in the left femoral neck. Left hip X-ray and pelvic CT revealed comminuted, impacted transcervical and subcapital fracture of the left femoral neck. Sensation and pulses were intact in bilateral lower extremities. Exam showed left hip tenderness, 3/5 left lower extremity strength secondary to pain, and 5/5 right lower extremity strength. Pain is 3/10 in severity and exacerbated by movement. A 74-year-old male presented to the emergency department with left hip pain after falling off his bicycle.
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