- To provide educational review of causes of acute hip pain other than a fracture neck of femurwith an overview of10 different causes.
- To describe the corresponding findings in various imaging modalities.
Acute hip pain is a common presentation to emergency departments.
In many cases the pain is attributed to neck of femur fracture clinically but the subsequent imaging confirms an alternative diagnosis.
We present examples of alternative causes for acute hip pain diagnosed at our institution including avulsion of the quadratus femoris tendon,
avulsion of the iliopsoas tendon,
avulsion of the common tendon of the hamstring muscles,sacral insufficiency fracture,
iliac and acetabular fractures,lower lumbar discitis,
calcific tendinitisandstress fracture of the femoral neck.
Imaging findings OR Procedure Details
Case 1: 90 years old female,
presented with right hip pain following a fall.
The images demonstrate avulsion of the right iliopsoas tendon from the lesser trochanter (Figure 1).
Case 2: 38 years old female,
presented after mechanical fall.
The images demonstrate sacral insufficiency fracture (Figure 2).
Case 3:70 years old male,
presented with acute right hip pain following a fall.
The coronal T1 and STIR images demonstrate displaced fracture of the right iliac crest anteriorly with soft tissue oedema of the right gluteus minimus,...
Early imaging of patients with acute hip pain aims to exclude a neck of femur fracture as it is associated with high morbidity and mortality.
NICE guidelines recommend surgery within the same day of admission or the day after when the fracture is confirmed 1.
Therefore MRI is performed in all patients with normal pelvic radiograph and high clinical suspicion for a fracture,
if there is no contraindication.
Alternative diagnoses other than femoral neck fracture have been frequently reported in patients with history of acute...
Hip fracture: management | 1-recommendations | Guidance and guidelines | NICE.
[online] Available at: http://www.nice.org.uk/guidance/cg124/chapter/1-recommendations [Accessed 9 Dec.