#NoF – Beware Occult Hip Fractures

Studies suggest around 1% of hip fractures are missed on plain X-ray. So as usual you must combine clinical  and radiological findings.

  1. Clinically assess ALL falls for hip injury
  2. NOT clinically excluded (e.g. hip pain, reduced ROM, not mobile) – X-Ray Hip + Pelvis
    • Hip fracture confirmed – treat as appropriate (#NoF guide-HERE)
    • NO hip fracture – Assess & Document pain and mobility
      • Comfortable and back to former mobility  – Consider discharge
      • Clinical suspicion of hip fracture – Admit to frailty  (for analgesia, physio assessment and potential for CT/MRI)

Not all of these patients will require further imaging – after a period of analgesia and physio assessment

What imaging? NICE recommend the use of MRI (unless contraindicated or delay >24hr) however more evidence is becoming available for the use of CT.

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