0:00

This is a case of a person with left hip pain after a fall

0:04

and unable to bear weight.

0:06

We have two projections here, a frontal projection

0:09

of the pelvis and proximal femurs,

0:12

and then a cross table lateral of the hip.

0:14

So on our frontal projection,

0:16

this is focused more on the hip and proximal femur.

0:19

So we have exclusion of the top portion of the iliac wings

0:24

and the person is presenting with left-sided symptoms.

0:27

So if we go through our checklist, we have our IOP pone

0:32

ILI issue line on the left is maintained

0:34

similar to the right.

0:36

Teardrop is fairly symmetric. SI joints are maintained.

0:42

Pubic synthesis is not diastasis.

0:45

What we can see of the arcuate lines are preserved.

0:49

The hip joint spaces are fairly well preserved

0:51

with some small acetabular osteophytes.

0:54

And now when we get into the hip morphology,

0:58

we can see on the right that we have preservation

1:01

of those load-bearing trabecula.

1:04

We also have maintained hemispheric of the femoral head

1:08

and then the head neck junction is smooth.

1:11

On the left we see that the head neck junction

1:15

show some minimal valgus angulation.

1:18

That's asymmetric to the right.

1:22

So then if we turn our attention to the hip

1:25

and proximal femur, we can see on the left

1:29

that the femoral head spasticity is maintained.

1:32

We can see the preservation of the load-bearing Trabecula

1:37

head neck junction is smooth.

1:40

On the left we have maintained ity of the left femoral head.

1:45

However, the head neck junction

1:48

does not have this smooth contour.

1:50

There is a bit of valgus or outward angulation.

1:55

There is a region of sclerosis along that femoral neck

1:59

that's asymmetric to the right.

2:01

And let's zoom in on the left.

2:04

So with our pan and zoom, we can see

2:06

that this side has this transverse band, little bit

2:10

of valgus angulation as opposed to the normal

2:13

configuration on the right side.

2:16

If we look at our cross table lateral,

2:19

there's no substantial displacement here

2:21

and confirms that there's no dislocation of the hip joint.

2:26

And so this radiography shows

2:29

that there's a minimally impacted

2:31

and essentially non-displaced subcapital

2:34

femoral neck fracture.

2:36

Given the history, we presume it's related

2:39

to the recent trauma, but it's really age in determinate

2:42

and sometimes MRI can be done to identify the acuity, given

2:46

that it has this little bit of sclerosis here.

Case: Subcapital Femoral Neck Fracture

HIDE

Prev Next

Interactive Transcript

Pro Tip: Click on a word in the transcript to jump to that point in the video