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Related Experiment Videos

Pseudopathologic hip fracture: anatomic explanation.

T R Duncan, A J Gerlock, C A Muhletaler

    AJR. American Journal of Roentgenology
    |October 1, 1980
    PubMed
    Summary

    Hip fractures can cause external rotation of the femur, making the bone appear dense, especially in older women. This visual artifact, caused by cortical thickness variations, must be differentiated from a pathologic fracture.

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    Area of Science:

    • Radiology
    • Orthopedic Surgery
    • Medical Imaging

    Background:

    • Hip fractures are common, particularly in elderly individuals.
    • External rotation of the femoral diaphysis can occur following hip fracture.
    • This displacement can lead to characteristic changes in radiographic appearance.

    Purpose of the Study:

    • To describe the radiographic appearance of the proximal femoral diaphysis following hip fracture.
    • To explain the underlying cause of the homogeneous density observed in some cases.
    • To differentiate this appearance from that of a pathologic fracture.

    Main Methods:

    • Review of radiographic and computed tomography (CT) findings in patients with hip fractures.
    • Analysis of femoral diaphysis morphology and cortical thickness variations.
    • Comparison with imaging features of pathologic fractures.

    Main Results:

    • External rotation of the femoral diaphysis after hip fracture can cause a homogeneously dense appearance of the proximal diaphysis.
    • This density is attributed to variations in cortical thickness in anteroposterior and mediolateral planes.
    • Computed tomography (CT) confirms these cortical variations.

    Conclusions:

    • The homogeneously dense appearance of the proximal femoral diaphysis in the context of hip fracture is an imaging artifact.
    • Radiologists and clinicians must be aware of this finding to avoid misdiagnosis.
    • Distinguishing this appearance from a pathologic fracture is crucial for appropriate patient management.

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