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Bone scanning for suspected hip fractures. A prospective study in elderly patients
The Journal of Bone and Joint Surgery. British Volume
|March 1, 1987
Summary
In elderly patients with suspected hip fractures, normal X-rays do not rule out injury. Isotope bone scans are recommended for doubtful cases, accurately identifying fractures missed by radiography.
Area of Science:
- Orthopedics
- Nuclear Medicine
- Geriatric Medicine
Background:
- Hip fractures are a common and serious injury in the elderly population.
- Conventional radiography is the primary imaging modality for suspected hip fractures.
- Radiographic sensitivity can be limited, potentially leading to missed diagnoses.
Purpose of the Study:
- To evaluate the utility of isotope bone scanning in elderly patients with suspected hip fractures and normal initial radiographs.
- To determine the diagnostic accuracy of bone scintigraphy in this patient cohort.
Main Methods:
- A retrospective review of 693 elderly patients admitted with suspected hip fractures.
- Isotope bone scan was performed on 43 patients with initially normal radiographs.
- Patient outcomes, including fracture development and displacement, were tracked.
Main Results:
- Of 43 patients with normal radiographs, 13 showed specific abnormalities on bone scan, all confirmed fractures.
- Five of these fractures subsequently displaced.
- The remaining 30 patients with normal bone scans were mobilized without developing fractures.
Conclusions:
- Conventional radiography is insufficient to exclude femoral neck fractures in elderly patients.
- Isotope bone scanning is a valuable diagnostic tool in cases of suspected hip fracture with normal radiographs.
- Early diagnosis and management can be improved by utilizing bone scintigraphy in equivocal situations.