Sixty-two consecutively seen patients in whom a fracture about the hip
was clinically suspected, but in whom the radiographic findings were
negative, were examined with both magnetic resonance imaging and
bone-scanning. The magnetic resonance-imaging studies, consisting of
T1-weighted coronal sections, were done within twenty-four hours after
admission to the hospital, and the bone scans, within seventy-two hours
after admission. There were twenty-three men and thirty-nine women.
Thirty-six patients who had evidence of a fracture on the magnetic
resonance-imaging study also had a positive bone scan initially.
Twenty-three patients who had a negative finding on the magnetic
resonance-imaging study had a corresponding negative bone scan. Two
additional patients had evidence of avascular necrosis of the femoral head
on both the magnetic resonance image and the bone scan, and they were
managed non-operatively. One patient had a positive magnetic resonance
image and a negative bone scan twenty-four hours after admission. A repeat
bone scan, which was made six days later, was positive for a fracture of
the femoral neck and the patient was managed with internal fixation.
Magnetic resonance imaging was as accurate as bone-scanning in the
assessment of occult fractures of the hip. The magnetic resonance imaging
took less than fifteen minutes to perform, and it was tolerated well by the
patient. Magnetic resonance imaging provides an early diagnosis of occult
fractures about the hip and may decrease the length of the stay in the
hospital by expediting definitive treatment.