Hip Fracture

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.


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Author: Shannon Erstad, MBA/MPHLast Updated: July 9, 2007
Medical Review: William M. Green, MD - Emergency Medicine
Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma

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