The use of MRI in the diagnosis of occult hip fractures in the elderly: a preliminary review.

Establishing the diagnosis of a non-displaced hip fracture in an elderly patient can be a prolonged and costly procedure, involving hospital admission, several days of bed rest, and a bone scan 3 to 5 days later. The authors evaluated 10 hips in 10 patients with a questionable diagnosis of non-displaced hip fracture. Magnetic resonance imaging (MRI) soon after admission revealed four patients with acute hip fractures who were subsequently treated. The other six patients, whose scans were negative for either femoral neck or intertrochanteric fractures, were mobilized. The authors show that, through the use of an immediate MRI study of a questionable hip fracture, the prolonged recumbency and inherent costs associated with awaiting a positive bone scan can be avoided.