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Occult Hip Fracture: A Clinical & Radiological Correlation

Author(s): P. Hak , J. Lewis, C. Carpenter, S. Roy, J. Davies.

Journal: Journal of Orthopaedics
ISSN 0972-978X

Volume: 6;
Issue: 4;
Date: 2009;
Original page

Keywords: Occult hip fracture | straight leg raise | diagnosis hip fracture

A prospective, multi-centre study was devised to investigate the correlation between the clinical findings of patients presenting with traumatic hip pain and the presence of occult hip fracture diagnosed on MRI. 32 patients admitted with a suspected occult hip fracture had both hips assessed for evidence of resting limb deformity, point tenderness, hip pain on heel percussion, pistoning and ability to straight leg raise (SLR). Plain radiographs and MRI findings were also recorded in each case and correlated with the findings. 23 out of 32 patients were unable to SLR on the affected side and 21 of those had a fracture of the pelvis or proximal femur on MRI. 9 patients could SLR of which 6 had no fractures and 3 had a fracture of the pelvis or proximal femur on MRI. The results show that the SLR test is 92% sensitive and 75% specific for predicting the presence of a fracture in either the proximal femur or pelvis and is therefore recommended as a simple, reliable test to expedite the investigation, diagnosis and further management of occult hip fractures.
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