Exams and Tests
Hip fractures usually are diagnosed with a physical exam and
X-rays. Signs of
hip fracture include pain in the groin, thigh, and
knee, being unable to move the leg, and the leg being shorter than the other
and rotated to the outside.
In some cases a fracture is not visible on the initial X-ray, but
your doctor will still suspect a hip fracture because of your hip pain or
recent fall. In these cases, your doctor may suggest other tests, such
as:
- An
MRI (magnetic resonance imaging), which provides
better images of bone and soft tissues.
- A
CT scan (computed tomography), another way of
providing more specific images than X-ray.
- A
bone scan, which involves injecting a dye, then taking
images that show hairline fractures (the bone is cracked, but all pieces are
still in place).
Fractures that were not clearly visible on an X-ray may show up on
an MRI, a CT scan, or a bone scan.
Women who have been through
menopause and have a hip fracture also may have
osteoporosis or be at a higher risk for it. A
bone mineral density test for osteoporosis may provide
early detection and lead to treatment that can help prevent future
fractures.
The level of a chemical in the blood called homocysteine has been
shown to predict the risk of fractures associated with osteoporosis. This can
be evaluated through a blood test and is treated by getting adequate folic
acid.3, 4 This test is not
widely used at this time.
To prevent hip fractures, health professionals should ask older
people at least once a year whether they have fallen. If a single fall has
occurred, a simple test should be done to assess the risk of more falls. Your
health professional will watch you stand up from a chair without using your
arms, walk several paces, and return (called the "get up and go test"). If you
have any difficulty or unsteadiness, you need further assessment. This includes
a detailed medical history, a review of your medicines, and an examination of
vision, balance, and muscle strength.