Pelvis/Hip Case 5 Diagnosis

Femoral Neck Fracture

Routine imaging should include AP pelvis and AP/lateral hip films. A method of detecting subtle fractures was described by Shenton, which involves looking for a disruption along a smooth curvilinear line along the superior border of the obturator foramen and the medial aspect of the femoral metaphysis (see additional images).

Some fractures will still elude plain films (2-9% of hip fractures are occult). If the clinical suspicion for femoral neck fracture remains high because of severe pain and inability to ambulate despite negative plain films, a CT or MRI is indicated.