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Hip fractures in adults.

Lance C Brunner1, Liza Eshilian-Oates, Tony Y Kuo

  • 1Southern California Permanente Medical Group, Santa Ana, California, USA.

American Family Physician
|February 18, 2003
PubMed
Summary

Occult hip fractures can be difficult to diagnose, presenting with vague pain and normal initial X-rays. Maintaining a high index of suspicion in older adults with leg discomfort is crucial for timely diagnosis and treatment.

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Area of Science:

  • Orthopedics
  • Geriatric Medicine
  • Radiology

Background:

  • Hip fractures are common in older adults, often resulting from falls.
  • Typical presentations include inability to walk, hip pain, and limb deformity.
  • Occult hip fractures present atypically, with vague pain and normal initial imaging, complicating diagnosis.

Purpose of the Study:

  • To highlight the diagnostic challenges of occult hip fractures.
  • To emphasize the importance of a high index of suspicion for early detection.
  • To guide healthcare providers in evaluating patients with suspected hip fractures.

Main Methods:

  • Review of clinical presentations of hip fractures.
  • Discussion of diagnostic imaging modalities (X-ray, MRI, bone scan).
  • Identification of risk factors and red flags for occult hip fractures.

Main Results:

  • Occult hip fractures may not present with classic symptoms or radiographic findings.
  • Vague pain in the hip, groin, thigh, knee, or back can indicate an occult fracture.
  • Advanced imaging may be required when initial evaluation is inconclusive.

Conclusions:

  • A high index of suspicion is essential for diagnosing occult hip fractures, especially in patients over 65.
  • Prompt diagnosis and treatment of hip fractures minimize morbidity and mortality.
  • Early detection prevents a decline in quality of life associated with hip injuries.

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