X-rays fail to spot up to nearly a third of fractures in the bones of the hip and pelvis, research suggests. Doctors from Duke University warn that relying on standard X-rays alone to give a clean bill of health could lead to wrong diagnoses and law suits.
When they re-checked the X-ray results of 92 patients using MRI, they found 35 fractures had been missed. In the study of patients complaining of pain after an injury to the hip or pelvis, 13 with normal X-ray findings were found to have a collective total of 23 fractures seen on MRI (magnetic resonance imaging). Another 15 patients with abnormal X-rays had 12 additional pelvic fractures seen on MRI that otherwise would not have been identified. And in 11 patients, MRI showed no fracture after X-rays had suggested there might be one.
The researchers say it is worth using MRI as well as an X-ray if doctors are in any doubt, particularly since hip patients tend to be frail and elderly with a higher than average risk of complications and death.
Dr Tony Nicholson, from the Royal College of Radiologists in the UK, said the findings quantified something already known or suspected. But he did not think it would be feasible or sensible to give every patient an MRI scan.
“Ultimately, it comes down to clinical acumen. If an elderly patient has persistent pain even though their X-ray shows only minor arthritis, an MRI would be a very reasonable request to check that there is not a fracture.”
[Source]
Chapter: Health :: 19 May 2010
