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Occult hip fracture

George Grammatopoulos, Catherine McCarthy, Alberto Carli, Wade Gofton
No abstract text is available yet for this article.
April 2, 2018: British Journal of Hospital Medicine
Jai Hyung Park, Hyun Chul Shon, Jae Suk Chang, Chul-Ho Kim, Seong-Eun Byun, Byeong Ryong Han, Ji Wan Kim
INTRODUCTION: The purpose of this study was to evaluate the proportion of greater trochanter (GT) fractures with occult extension to the intertrochanteric region on magnetic resonance imaging (MRI) among apparently isolated GT fractures and to investigate the use of MRI for formulating a treatment strategy in patients with isolated GT fractures. PATIENTS AND METHODS: This retrospective cohort study reviewed 37 patients with isolated GT fractures on plain radiography...
March 15, 2018: Injury
Nataliya P Buxbaum, Cemre Robinson, Ninet Sinaii, Alexander Ling, Lauren M Curtis, Steven Z Pavletic, Kristin Baird, Maya B Lodish
Pediatric allogeneic hematopoietic stem cell transplantation (AHSCT) recipients with chronic graft-versus-host disease (cGVHD) are at high risk for endocrinopathies, particularly impaired bone mineral density (BMD). However, rates of BMD impairment in pediatric AHSCT recipients with cGVHD have not been well documented. We report 33 patients with cGVHD who were referred to the National Institutes of Health (NIH) for the Natural History of Clinical and Biological Factors Determining Outcomes in Chronic Graft-versus-Host Disease Study (NCT 0092235) and underwent formal BMD assessment via dual-energy X-ray absorptiometry (DEXA)...
March 1, 2018: Biology of Blood and Marrow Transplantation
Denise R Ramponi, Judith Kaufmann, Gwendolen Drahnak
Hip fractures are associated with significant morbidity and mortality and a major health problem in the United States (). Eighty percent of hip fractures are experienced by 80-year-old women. Plain radiographs usually confirm the diagnosis, but if there is a high level of suspicion of an occult hip fracture, magnetic resonance imaging or bone scan is the next step to confirm the diagnosis. Areas of the hip bone have varied bone strength and blood supply, making the femoral neck one of the most vulnerable areas for fracture...
January 2018: Advanced Emergency Nursing Journal
Jacob C Mandell, Michael J Weaver, Bharti Khurana
PURPOSE: The purpose of this study was to evaluate the diagnostic performance of CT for assessment of occult fractures of the proximal femur, pelvis, and sacrum. MATERIALS AND METHODS: A retrospective review was performed on patients who received a CT of the hip or pelvis for suspected occult fracture after negative or equivocal radiographs performed within 24 h. The official radiology report was utilized for the determination of CT findings and calculation of sensitivity and specificity...
January 11, 2018: Emergency Radiology
A V Gurava Reddy, Krishna Kiran Eachempati, Aakash Mugalur, A Suchinder, V B N Prasad Rao, Nalanda Kamurukuru
INTRODUCTION: Periprosthetic fractures and dislocation in the early post-operative period can be disastrous both for the surgeon and the patient. However, undisplaced periprosthetic fractures presenting with dislocation is uncommon. We describe successful management of two cases (one bilateral dislocation and one unilateral dislocation) of undisplaced iatrogenic fractures in total hip arthroplasty (THA) presenting as early dislocation. CASE REPORT: Case 1 was a 45-year-old female with osteoarthritis of hip secondary to developmental dysplasia of the hip with bilateral early nontraumatic dislocation with bilateral identical periprosthetic fracture...
May 2017: Journal of Orthopaedic Case Reports
Nazeer M Dareez, Kristine H Dahlslett, Eirin Engesland, Elisabeth S Lindland
We aimed to determine whether bone marrow edema (BME) in acute traumatic scaphoid fracture could be demonstrated with dual-energy CT (DECT) using MRI as the gold standard. In recent years, virtual non-calcium (VNCa) images have been used to demonstrate BME in trauma cases, for example, in vertebral compression fractures, hip trauma to detect occult fractures and knee fractures. We present three cases of acute scaphoid trauma. Two patients had subtle or invisible fractures on x-ray and conventional CT images, while DECT VNCa images clearly visualized the BME, which was confirmed by MRI...
December 2017: Skeletal Radiology
Ana Pejic, Susanne Hansson, Cecilia Rogmark
INTRODUCTION: Hip fractures are commonly diagnosed by plain radiography. When a patient presents with negative radiographs and high clinical suspicion of fracture, guidelines recommend proceeding with magnetic resonance imaging (MRI) to diagnose the patient. The aim of this study was to assess the use of MRI in diagnosing hip fractures following trauma to the hip and describe clinical outcome after MRI-diagnosed hip fractures. The perspective was to develop new recommendations for MRI use...
March 2017: Injury
Mats Geijer, Olof Laurin, Ragnar Johnsson, Sven Laurin
BACKGROUND: A thorough quality analysis of radiologic performance is cumbersome. Instead, the prevalence of missed cervical hip fractures might be used as a quality indicator. PURPOSE: To validate a computer-based quality study of cervical hip fracture radiography. MATERIAL AND METHODS: True and false negative and positive hip trauma radiography during 6 years was assessed manually. Patients with two or more radiologic hip examinations before surgery were selected by computer analysis of the databases...
December 2016: Acta Radiologica Open
Kazuhiro Hasegawa, Tamon Kabata, Yoshitomo Kajino, Daisuke Inoue, Hiroyuki Tsuchiya
BACKGROUND: Periprosthetic fractures of the acetabulum occurring during primary THA are rare. Periprosthetic occult fractures are defined as those not identified by the surgeon during the procedure which might be missed on a routine postoperative radiograph. However, it is unclear how frequently these fractures occur and whether their presence affects functional recovery. QUESTIONS/PURPOSES: In this study, using routine CT scans that were obtained as part of another primary hip arthroplasty study protocol, we retrospectively assessed (1) the prevalence of occult fractures of the acetabulum occurring during primary THA, (2) the location of occult fractures of the acetabulum during THA, and (3) risk factors contributing to such occult fractures...
February 2017: Clinical Orthopaedics and related Research
Z Sadozai, R Davies, J Warner
Non-displaced hip fractures can be difficult to diagnose on plain film radiographs. When there is ongoing clinical suspicion of an occult fracture, further imaging is obtained. We investigated the sensitivity of computed tomography (CT) scans in detecting these fractures and the delays to surgery that three-dimensional imaging causes. We identified 78 CT scans performed for possible hip fractures over the past 3 years with the presence and absence of a fracture recorded. Based on subsequent imaging, the accuracy of CT scans was determined...
December 2016: Injury
Saurabh Vitalkar, Ashmi S Manglunia, Arvind Kulkarni, Ameya D Puranik
Stress insufficiency fracture is usually diagnosed clinically and on the basis of routine X-ray imaging findings. However, the absence of any known predisposing factors and negative or occult radiographic findings pose diagnostic challenges. We report the case of an elderly male patient who presented with a chief complaint of trivial left hip pain and with equivocal radiographic findings. Triphasic (99m)Tc-methylene diphosphonate bone scan and single-photon emission computed tomography/computed tomography helped in arriving at the diagnosis of stress insufficiency fracture involving femoral neck...
July 2016: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Brian J Yun, M G Myriam Hunink, Anand M Prabhakar, Marilyn Heng, Shan W Liu, Rameez Qudsi, Ali S Raja
OBJECTIVE: Hip fractures cause significant morbidity and mortality. Determining the optimal diagnostic strategy for the subset of patients with potential occult hip fracture remains challenging. We determined the most cost-effective strategy for the diagnosis of occult hip fractures from the choices of performing only computed tomography (CT), performing only magnetic resonance imaging (MRI), performing CT and if negative performing MRI (MRI-selective strategy) or discharging the patient without advanced imaging...
October 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Haroon Rehman, Rhys G E Clement, Fergus Perks, Timothy O White
OBJECTIVES: Patients presenting with hip pain but normal plain radiographs may ultimately be shown on further investigation to have suffered an occult hip fracture (OHF). This diagnosis can be made with CT or MRI. Traditionally MRI has been considered a superior modality. We performed a retrospective review of all patients presenting to our service with a suspected OHF over a four-year period, investigated with either CT or MRI. DESIGN: Retrospective review. SETTING: Urban trauma centre...
June 2016: Injury
Till O Klatte, Reza Sabihi, Daniel Guenther, Atul F Kamath, Johannes M Rueger, Thorsten Gehrke, Daniel Kendoff
BACKGROUND: Existing hardware may contribute to increased risk of bacterial contamination and subsequent periprosthetic joint infection (PJI) in conversion shoulder arthroplasty performed for failed fracture fixation. QUESTIONS/PURPOSES: This study examined the incidence of positive pre-operative aspiration and inflammatory marker data, along with correlation of pre-operative positive aspiration or inflammatory markers and subsequent infection following conversion shoulder arthroplasty for failed open reduction and internal fixation (ORIF) and the need for re-operation at 4...
October 2015: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
David Collin, Jan H Göthlin, Martin Nilsson, Mikael Hellström, Mats Geijer
The influence of experience in categorizing suspect and occult fractures on radiography compared to MRI and clinical outcome has not been studied. The aim of this study is to evaluate the importance of experience in diagnosing normal or suspect hip radiographs compared to MRI. Primarily reported normal or suspect radiography in 254 patients with low-energy hip trauma and subsequent MRI was re-evaluated by two experienced reviewers. Primary readings and review were compared. The prevalence of fractures among normal and suspect radiographic studies was assessed...
June 2016: Emergency Radiology
Rhys W Thomas, Huw L M Williams, Eleanor C Carpenter, Kathleen Lyons
OBJECTIVE: 10% of all hip fractures are occult on plain radiography, requiring further investigation to ascertain the diagnosis. MRI is presently the gold standard investigation, but frequently has disadvantages of time delay, resulting in increased hospital stay and mortality. Our aim was to establish whether multidetector CT (MDCT) is an appropriate first-line investigation of occult femoral neck (NOF) fractures. METHODS: From 2013, we elected to use MDCT as the first-line investigation in patients believed to have an NOF fracture with negative plain films...
2016: British Journal of Radiology
Alka Sudhir Karnik, Alpana Karnik, Alpana Joshi
Ultrasound (US) is a simple, non-invasive imaging modality which allows high-resolution imaging of the musculoskeletal (MSK) system. Its increasing popularity in pediatrics is due to the fact that it does not involve radiation, has an ability to visualize non-ossified cartilaginous and vascular structures, allows dynamic imaging and quick contralateral comparison. US is the primary imaging modality in some pediatric MSK conditions like infant hip in developmental dysplasia (DDH), hip joint effusion, epiphyseal trauma and evaluation of the neonatal spine...
June 2016: Indian Journal of Pediatrics
David Collin, Mats Geijer, Jan H Göthlin
BACKGROUND: Computed tomography (CT) for evaluation of occult and suspect hip fractures has been proposed as a good second-line investigation. The diagnostic precision compared to magnetic resonance imaging (MRI) is unclear. PURPOSE: To compare the diagnostic performance of CT and MRI in a retrospective study on patients with suspect and occult hip fractures. MATERIAL AND METHODS: Forty-four elderly consecutive patients with low-energy trauma to the hip were identified where negative or suspect CT was followed by MRI...
November 2016: European Radiology
Sayantan Ray, Partha Pratim Chakraborty, Kaushik Biswas, Anne M Beatrice, Sujoy Ghosh, Satinath Mukhopadhyay, Subhankar Chowdhury
Authors describe a case of oncogenic osteomalacia in a 35-year-old man, who presented with a 2-year history of generalized pain and progressive weakness of lower limbs, eventually became bedbound. At admission, he had severe hip pain resulting from bilateral femoral neck fractures. Laboratory investigations revealed hypophosphatemia, hyperphosphaturia, normocalcemia, elevated alkaline phosphatase and normal serum levels of parathormone and 25-hydroxyvitamin D. Serum fibroblast growth factor 23 (FGF23) level was elevated...
April 2015: Oxford Medical Case Reports
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