"The high morbidity and mortality associated with hip and pelvic fractures after trauma have been well documented. Prognosis is varied but is complicated by advanced age, as hip fractures increase the risk of death and major morbidity in the elderly 5,6,8, with all-cause mortality one year after hip fracture varying between ~14% (Singapore) and ~28% (United Kingdom) 4."
"Neck of femur (NOF) fractures, or femoral neck fractures, are common injuries sustained by older patients, who are more likely to have both gait unsteadiness and reduced bone mineral density, predisposing them to fracture. Elderly osteoporotic women are at greatest risk."
"Plain radiograph (sensitivity ~95%; specificity ~85% 25) is the first-line investigation for suspected NOF fractures. In patients with a suspected occult NOF fracture, MRI (sensitivity 99-100%) is recommended by many institutions as the second-line test if available within 24 hours, with CT or nuclear medicine bone scan as third-line 17,18. There is some evidence that thin-slice MDCT is as sensitive as MRI 19."
"Plain radiograph (sensitivity ~95%; specificity ~85% 25) is the first-line investigation for suspected NOF fractures. In patients with a suspected occult NOF fracture, MRI (sensitivity 99-100%) is recommended by many institutions as the second-line test if available within 24 hours, with CT or nuclear medicine bone scan as third-line 17,18. There is some evidence that thin-slice MDCT is as sensitive as MRI 19."
"AP pelvis and lateral hip should be viewed because pelvic fractures can mimic the clinical features of hip fracture"
"Shenton’s line disruption: loss of contour between normally continuous line from medial edge of femoral neck and inferior edge of the superior pubic ramus"
Expected headings
"Mechanism"
"Report checklist"
"Femoral neck fractures are a subset of proximal femoral fractures. The femoral neck is the weakest part of the femur. Hip fractures can be divided into intracapsular and extracapsular fractures, with 60% intracapsular; of these, 80% are displaced 20."
"Plain radiograph (sensitivity ~95%; specificity ~85% 25) is the first-line investigation for suspected NOF fractures. In patients with a suspected occult NOF fracture, MRI (sensitivity 99-100%) is recommended by many institutions as the second-line test if available within 24 hours, with CT or nuclear medicine bone scan as third-line 17,18. There is some evidence that thin-slice MDCT is as sensitive as MRI 19."
"Since disruption of blood supply to the femoral head is dependent on the type of fracture and causes significant morbidity, the diagnosis and classification of these fractures are important. There are three types:"
"In elderly patients, the mechanism of injury varies from falls directly onto the hip to a twisting mechanism in which the patient’s foot is planted and the body rotates. There is generally deficient elastic resistance in the fractured bone 8."
"Plain radiograph (sensitivity ~95%; specificity ~85% 25) is the first-line investigation for suspected NOF fractures. In patients with a suspected occult NOF fracture, MRI (sensitivity 99-100%) is recommended by many institutions as the second-line test if available within 24 hours, with CT or nuclear medicine bone scan as third-line 17,18. There is some evidence that thin-slice MDCT is as sensitive as MRI 19."