Northwestern University Feinberg School of Medicine

Orthopedic Teaching

Pelvis/Hip Case 7 Background

Occult Hip Fracture


Background

Depending on the source, there are between 250,000-340,000 hip fractures treated in the U.S annually. About half of these fractures occur in people 85 years of age and older. One in three women and one in six men who reach age 90 will fracture a hip during their lifetime. Between 2% and 9% of hip fractures are occult - that is, x rays are negative.

Hip pain in the young, athletes, and the elderly deserves investigation even when there is minimal or no trauma reported as this population commonly suffers from occult hip pathology. Pathologic fractures may result from osteoporosis (most common cause of femoral neck fractures with minor trauma), metastatic, metabolic, or endocrine disease.

These occult fractures are clinically significant because delay in the diagnosis leads to considerable increase in morbidity through unnecessary pain, avascular necrosis of the femoral head, nonunion, thromboembolic complications, and increased mortality.