The Dislocated Hip on CT Scan: An Argument for the Initial Pelvic Radiograph in Trauma Patients

Area of Science:

• Orthopaedic Surgery
• Radiology
• Trauma Care

Background:

• Hip dislocations are common orthopaedic emergencies.
• Initial imaging protocols for hip dislocations vary.
• Computed tomography (CT) scans are frequently used for diagnosis and management.

Purpose of the Study:

• To evaluate the diagnostic pathway for hip dislocations.
• To determine the impact of initial imaging modality on subsequent CT scans.
• To assess the effectiveness of closed reduction prior to CT in reducing repeat scans.

Main Methods:

• Retrospective review of 83 hip dislocation cases at a Level 1 trauma center.
• Analysis of initial imaging (pelvic radiograph [PXR] vs. CT scan).
• Documentation of closed reduction timing and repeat CT scan incidence.

Main Results:

• 64 patients initially received CT scans for hip dislocation.
• 19 patients had initial PXR and closed reduction before CT.
• Repeat CT scan rates decreased from 37% to 11% (p=0.046) when PXR and reduction preceded CT.

Conclusions:

• Initial diagnosis of hip dislocation with PXR followed by closed reduction can decrease repeat CT scans.
• This strategy reduces healthcare costs and patient radiation exposure.
• Optimizing imaging and reduction protocols is crucial in hip dislocation management.