Neck of femur fracture differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Neck of femur fracture must be differentiated from other causes of acute [[hip]] pain, [[restriction of movements]], and [[deformity]] such as [[intertorchanteric hip fracture]], [[osteoarthritis]], [[avascular necrosis]], [[septic arthritis]] and acute [[synovitis]]. | Neck of femur fracture must be differentiated from other causes of acute [[hip]] pain, [[restriction of movements]], and [[deformity]] such as [[intertorchanteric hip fracture]], [[osteoarthritis]], [[avascular necrosis]], [[septic arthritis]], [[Trochanteric bursitis|trochanteric]] [[bursitis]], [[slipped capital femoral epiphysis]] and acute [[synovitis]]. | ||
==Differentiating | ==Differentiating Neck of Femur Fracture from other Diseases== | ||
* Neck of femur fracture must be differentiated from other causes of acute [[hip]] pain, [[restriction of movements]], and [[deformity]] such as [[intertorchanteric hip fracture]], [[osteoarthritis]], [[avascular necrosis]], [[septic arthritis]] and acute [[synovitis]].<ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref><ref>{{cite book | last = Azar | first = Frederick | title = Campbell's operative orthopaedics | publisher = Elsevier | location = Philadelphia, PA | year = 2017 | isbn = 9780323374620 }}</ref> | * Neck of femur fracture must be differentiated from other causes of acute [[hip]] pain, [[restriction of movements]], and [[deformity]] such as [[intertorchanteric hip fracture]], [[osteoarthritis]], [[avascular necrosis]], [[septic arthritis]], [[Trochanteric bursitis|trochanteric]] [[bursitis]], [[slipped capital femoral epiphysis]] and acute [[synovitis]].<ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref><ref>{{cite book | last = Azar | first = Frederick | title = Campbell's operative orthopaedics | publisher = Elsevier | location = Philadelphia, PA | year = 2017 | isbn = 9780323374620 }}</ref> | ||
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MRI | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MRI | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Neck of Femur Fracture | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Intertrochanteric Hip [[Fracture]] | ||
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* It is pathgnomic of [[Anterior cruciate ligament|ACL]] tear | * It is pathgnomic of [[Anterior cruciate ligament|ACL]] tear | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | |Subtrochanteric Femur Fracture | ||
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|Acetabular Fracture | |||
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|Pubic Rami Fracture | |||
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|Femoral Head Fracture | |||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Osteoarthritis | |||
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* Inability to do [[Straight leg raise|straight leg raising]] test. | * Inability to do [[Straight leg raise|straight leg raising]] test. | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Trochanteric Bursitis | ||
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* Inability to do [[Straight leg raise|straight leg raising]] test. | * Inability to do [[Straight leg raise|straight leg raising]] test. | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Septic Arthritis | ||
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* Apprehension Test positive | * Apprehension Test positive | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Avascular Necrosis of Head of Femur | ||
(Osteonecrosis) | |||
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Acute Synovitis | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | + | | style="background: #F5F5F5; padding: 5px; text-align: center;" | + | ||
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
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* [[McMurray's test|McMurray's est]] positive for [[Tear of meniscus|meniscal injury]] | * [[McMurray's test|McMurray's est]] positive for [[Tear of meniscus|meniscal injury]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Slipped Capital Femoral Epiphysis | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | | style="background: #F5F5F5; padding: 5px; text-align: center;" | +/- | ||
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* [[Varus]] stress test is positive for [[Lateral collateral ligament|Lateral Collateral Ligament]] (LCL) | * [[Varus]] stress test is positive for [[Lateral collateral ligament|Lateral Collateral Ligament]] (LCL) | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Iliospoas Tendinitis | ||
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* Defect present superior to superior pole of [[patella]] | * Defect present superior to superior pole of [[patella]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Hip Pointer | ||
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* [[Adolescent|Adolescents]] are commonly affected by the disease. | * [[Adolescent|Adolescents]] are commonly affected by the disease. | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Snapping Hip Syndrome | ||
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| style="background: #F5F5F5; padding: 5px; text-align: center;" | - | | style="background: #F5F5F5; padding: 5px; text-align: center;" | - | ||
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* [[Doppler ultrasound]] and [[angiography]] of the [[lower limb]] confirms the [[disease]] | * [[Doppler ultrasound]] and [[angiography]] of the [[lower limb]] confirms the [[disease]] | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Maisonneuve fracture| | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Maisonneuve fracture|Osteitis Pubis]] | ||
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Revision as of 17:06, 18 February 2019
Neck of femur fracture Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Neck of femur fracture differential diagnosis On the Web |
American Roentgen Ray Society Images of Neck of femur fracture differential diagnosis |
Risk calculators and risk factors for Neck of femur fracture differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
Neck of femur fracture must be differentiated from other causes of acute hip pain, restriction of movements, and deformity such as intertorchanteric hip fracture, osteoarthritis, avascular necrosis, septic arthritis, trochanteric bursitis, slipped capital femoral epiphysis and acute synovitis.
Differentiating Neck of Femur Fracture from other Diseases
- Neck of femur fracture must be differentiated from other causes of acute hip pain, restriction of movements, and deformity such as intertorchanteric hip fracture, osteoarthritis, avascular necrosis, septic arthritis, trochanteric bursitis, slipped capital femoral epiphysis and acute synovitis.[1][2]
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||
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Symptoms | Physical examination | ||||||||||
Imaging | |||||||||||
Pain | Restriction of Movements | Deformity | Tenderness | Integrity of extensor mechanism | Distal Pulses | X-ray | CT scan | MRI | |||
Neck of Femur Fracture | + | + | +/- | + | + | +/- |
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CT | ||
Intertrochanteric Hip Fracture | + | + | - | + | + | + |
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MRI |
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Subtrochanteric Femur Fracture | |||||||||||
Acetabular Fracture | |||||||||||
Pubic Rami Fracture | |||||||||||
Femoral Head Fracture | |||||||||||
Osteoarthritis | + | + | + | + | - | + |
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X-ray |
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Trochanteric Bursitis | + | + | + | + | - | + |
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X-ray |
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Septic Arthritis | + | + | + | + | +/- | + |
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MRI |
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Avascular Necrosis of Head of Femur
(Osteonecrosis) |
+ | + | + | + | +/- | +/- |
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MRI |
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Diseases | Pain | Restriction of Movements | Deformity | Tenderness | Integrity of extensor mechanism | Distal Pulses | X-ray | CT scan | MRI | Gold standard | Additional findings |
Acute Synovitis | + | +/- | - | +/- | + | + |
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MRI |
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Slipped Capital Femoral Epiphysis | + | +/- | - | + | + | + |
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MRI |
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Iliospoas Tendinitis | + | + | + | + | - | + |
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MRI |
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Hip Pointer | + | + | - | + | + | + |
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X-ray |
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Snapping Hip Syndrome | + | - | - | + | + | - |
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Doppler ultrasound |
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Osteitis Pubis | + | + | + | + | + | + | CT confirms x-ray findings |
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X-ray |
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References
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
- ↑ Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.