Abstract

MRI IN EVALUATION OF PAINFUL HIP JOINT AND TO DETECT OCCULT OF PROXIMAL FEMUR FRACTURES

*Dr. Haider Khalil Hussein Al. Azzawi, Dr. Kalid Abdulabbas Farhan and Dr. Mahdi Mohsin Hameed Al. Yousuf

ABSTRACT

An MR scan was performed on all patients who presented to our hospital with a clinical diagnosis of a fracture of the proximal femur, but who had no abnormality on plain radiographs. This was a prospective study of 51 consecutive patients over a ten-year period. There were 48 patients who fulfilled our inclusion criteria, of whom 36 were scanned within 48 hours of admission, with an overall mean time between admission and scanning of 2.4 days (0 to 10). A total of40 patients (83%) had abnormalities detected on MRI; 11 (23%) required operative management. The use of MRI led to the early diagnosis and treatment of occult hip pathology. We recommend that incomplete intertrochanteric fractures are managed non-operatively with protected weight-bearing. The study illustrates the high incidence of fractures which are not apparent on plain radiographs, and shows that MRI is useful when diagnosing other pathology such as malignancy, which may not be apparent on plain films.

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