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Hip fractures

Zsolt Balogh trauma-list@trauma.org
Fri, 4 Jan 2002 07:25:55 -0800 (PST) 

I think MRI is superior to CT scan in clearing occult
fractures such as undisplaced hip fracture.

I do not know how the cost of false negativ CT scan
and the complications originating from that and the
higher cost of MRI is related.

Zsolt Balogh

--- Per Liljeholm <pliljeholm@hotmail.com> wrote:
> Hello
> 
> David Bleam answered Fri, 04 Jan:
> 
> Can easily happen--I have seen this on a number of
> occasions, usually with
> >subtle nondispaced fractures.  You must pay
> attention to your patient, and
> >continue x-rays, going to CT of the hip if
> necessary if clinical picture
> >suggests something more
> >ERF
> As an orthopaedic surgeon in Umeå Univ.hosp
> (Northern Sweden) we have
> always used the same approach with 2-4 days of
> careful mobilisation and
> if no signs of recovery then another x-ray to
> exclude a  nondisplaced
> fracture. We used conventional x-ray and then
> scintigram. Though you can 
> still miss a fracture with conventional x-ray and
> even with scint after 4 
> days we these days use MRI instead, as it can see
> the undisplaced fracture 
> at once. Our radiologist state that the MRI is by
> far both earlier and more 
> exact in finding undisplaced fractures if you
> compare with the CT scan. What 
> is your opinion? I suppose it´s a question of money
> and access to the MRI as 
> well.
> 
> Per Liljeholm
> pliljeholm@hotmail.com
> 
>
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