Kligman M, Roffman M
Dept. of Orthopedic Surgery, Carmel Medical Center, Haifa.
Harefuah. 1997 May 15;132(10):697-9, 743.
Painful hip as a result of injury, with or without a history of trauma, is a common reason for referring elderly patients to the emergency room. The diagnosis of femoral neck fracture requires the combination of a physical examination, X-rays, and in problematic cases, a bone scan. However, even this combination does not always provide a diagnosis. We present 50 patients with painful hip who complained of limp and reduced hip joint motion, but had no evidence of fracture, either on X-ray or bone scan. After conservative treatment, 5 patients with no history of trauma underwent hemiarthroplasty of the hip for displaced subcapital fracture. In addition, we present a case of subcapital fracture which was diagnosed only by MRI, in whom both X-rays and bone scan were considered normal.
因受伤导致的髋部疼痛,无论有无创伤史,都是老年患者被送往急诊室的常见原因。股骨颈骨折的诊断需要结合体格检查、X 光检查,在疑难病例中还需要进行骨扫描。然而,即使采用这种联合检查方法也并非总能确诊。我们报告了 50 例髋部疼痛的患者,他们主诉跛行且髋关节活动受限,但 X 光或骨扫描均未发现骨折迹象。经过保守治疗后,5 例无创伤史的患者因股骨头下移位骨折接受了髋关节半关节置换术。此外,我们还报告了 1 例仅通过 MRI 确诊的股骨头下骨折病例,其 X 光和骨扫描结果均被认为正常。