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.