Occult central acetabular fracture resulting in fracture-dislocation. A case report

A 71-year-old white female experienced a nondisplaced right central acetabular fracture in a motor vehicle accident. Despite anteroposterior (AP) roentgenograms of the pelvis, Judet views, and plain tomograms, no fracture was detected. These negative findings did not entirely explain the continued presence of pain. The patient was treated with physical therapy and encouraged to bear weight on the leg as tolerated. The fracture then progressed to a central fracture dislocation readily apparent on AP views of the pelvis. This case illustrates the need for further diagnostic studies (bone scanning, computed tomography, and magnetic resonance imaging) when, despite negative objective findings, a high degree of suspicion persists.