In the emergency department, fast diagnosis of pelvic and hip fractures can speed up the patient for appropriate treatment, such as medication and possibility to have surgical management.
Also fast diagnosis of those fractures could reduce the rate of hospital admissions among other patients who have no fracture.

However, using X-ray for diagnosing could missed number of fractures compare with magnetic resonance imaging (MRI) scanning result.

Despite side effects related to MRI may occur in further as our previous archive, for emergency treatment, fast diagnosis can help patient to get immediate treatment especially for older population which is hip fracture can lead to high morbidity and mortality.

Estimated report said that 12% - 37% mortality from hip fracture in 1 year.

Comparison diagnosing result between MRI and X-ray study recently investigated by researcher from the Department of Radiology of Duke University Medical Center, Durham, North Carolina.

Matthew Kirby, MD and Charles Spritzer, MD from the Duke University Medical Center, write as April issue in the American Journal of Roengenology from the result of their prospective study in 92 patients (77 women and 14 men) who arrived at the Duke emergency department with pain or suspected trauma (of 65 patients) with median age 70.8 years, and who later had a MRI scanning between July 2005 and June 2008.

The results;
- 13 patient or 14% of patients detected had 6 hip fracture and 7 pelvic fracture by MRI but not in X-ray
- 11 patient or 12% of patient ’suggested’ the presence of fractures by X-ray, but clearly not in MRI
- 15 patients (16%) with X-rays that did reveal fractures had MRIs that depicted additional breaks missed by X-ray.

From 59 patients showed no fracture with MRIs, of 43 patients (73%) revealed other conditions such as inflammation of the part of the hip–trochanteric bursa, muscle edema and tears, and hamstring tendinopathy.

As a conclusion the author write, “We found a large number of both false-positive and false-negative diagnoses based on radiographic findings alone. Use of MRI has a substantial advantage in the detection of pelvic and femoral fractures, helping to steer patients to appropriate medical and surgical therapy.”

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