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In patients with hip fracture, initial radiographs occasionally are negative. When the suspicion for fracture remains high despite negative x-ray findings, magnetic resonance imaging (MRI) generally is the next step for identifying an occult fracture; however, computed tomography (CT) is another option. Two new meta-analyses provide information on this clinical scenario.
One meta-analysis yielded these findings in patients with suspected hip fracture but no surgical fracture on initial x-rays:
Among patients with entirely negative hip x-rays, 39% had surgical hip fracture identified on MRI.
Among patients whose x-rays revealed only isolated greater trochanteric fracture (a nonsurgical finding), MRI showed that 92% had intertrochanteric extensi…