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28-03-2024 | Edema | Original Article

MRI characteristics of radiographically occult femoral neck fractures in trauma patients with ipsilateral femoral shaft fractures

Authors: Stephen Neville, Nathan Rogers, Stephen Warner, Nicholas M. Beckmann

Abstract

Purpose

Ipsilateral femoral neck fractures can be seen alongside femoral shaft fractures in high-velocity trauma patients. These neck fractures are often occult on radiographs and CT, and can have a significant impact on patient outcomes if not treated promptly. Limited protocol pelvic MRI has been used to increase sensitivity for these occult fractures. Detailed characterization of these fractures on MRI is lacking.

Methods

427 consecutive trauma patients presenting to our emergency department who had known femoral diaphyseal fractures but no ipsilateral femoral neck fracture on radiographs or CT were included in this study. These patients were scanned using a limited protocol MRI with coronal T1 and coronal STIR sequences. Presence of an ipsilateral femoral neck fracture and imaging characteristics of the fracture were obtained.

Results

31 radiographically occult ipsilateral femoral neck fractures were found, representing 7% of all cases. All neck fractures were incomplete. All fractures originated along the lateral cortex of the femoral neck and extended medially towards the junction of the medial femoral neck and the lesser trochanter. 58% (18/31) were vertical in orientation. 61% (19/31) did not demonstrate any appreciate edema on STIR images.

Conclusion

Implementation of limited protocol MRI protocol increases sensitivity for detection of femoral neck fractures in the setting of ipsilateral femoral shaft fractures not seen on radiograph or CT imaging. We describe the characteristic MR imaging features of these fractures.

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Title: MRI characteristics of radiographically occult femoral neck fractures in trauma patients with ipsilateral femoral shaft fractures
Authors: Stephen Neville
Nathan Rogers
Stephen Warner
Nicholas M. Beckmann
Publication date: 28-03-2024
Publisher: Springer International Publishing
Keyword: Edema
Published in: Emergency Radiology
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-024-02221-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

MRI characteristics of radiographically occult femoral neck fractures in trauma patients with ipsilateral femoral shaft fractures

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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