Background The majority of femoral neck fractures arereadily diagnosed on dedicated plain radiographs. However, around 3-4% of hip fractures can be occult,(1,2) resulting in a delayed diagnosis which can significantly increase morbidity and mortality.(3) NICE Guidance recommends MRI for suspected occult hip fracture within 24 hours, if dedicated radiographs are negative.(4) Aim We aim to audit the inpatient MRI waiting times for suspected occultfemoral neck fracture, identify the reasons for any delay, therebyimplement changes to reduce the delay and to improve waiting times. We then...

We performed a retrospective search on our Computed Radiology Information System (CRIS), for all MRIs that were performed with the clinical indication of querying occult hip fracture.The date range applied for Cycle 1 wasSeptember 2014 to August 2015 (12-month period), and Cycle 2 covers August 2016 to July 2017 (12-month period). We collected data on date and time of MRI request, MRI scanning, and MRI report verification.

Results of Cycle 1 There were 105 MRIs that fulfilled the search criteria. There were 30 femoral neck fractures (28.6%) detected on the 105 MRIs. Percentage of scans waiting for <24 hours From request to scan 67.6% (n=71) From scan to report 51.4% (n=54) From request to report 29.5% (n=31) Mean waiting times From request to scan 32.3 hours From scan to report 47.0 hours From request to report 79.2 hours Review of results (reasons for delayed reporting) No ownership of the MRI scans, therefore...

•Great improvement in waiting time for report after MRI scan –This reflects the effectiveness of the daily MSK Consultant rota providing prompt inpatient MRI reporting –May also be helped by a MSK Consultant and MSK Sonographer returning to clinical work •Some increased waiting time for MRI scan –Due to more clinical demand for MRI –Outside the control of reporting Radiologists •Overall, mean waiting time from request to report has improved –This reflects how well the reporting Radiologists are performing, being able to partially offset and...

Gill SK, Smith J, Fox R, Chesser TJ. Investigation of occult hip fractures: the use of CT and MRI. Scientific World Journal. 2013;2013:830319. Deleanu B, Prejbeanu R, Tsiridis E, Vermesan D, Crisan D, Haragus H, et al. Occult fractures of the proximal femur: imaging diagnosis and management of 82 cases in a regional trauma center. World Journal of Emergency Surgery. 2015;10(1):55. Kim KC, Ha YC, Kim TY, Choi JA, Koo KH. Initially missed occult fractures of the proximal femur in elderly patients: implications for need...

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