An old lady had a history of fall in bathroom once and couldn't move. Afterwards, she had leg in externally rotated position. There was tenderness in Scarpa's triangle and limb movement could not been done due to pain. No hip fracture was seen on X-Ray. Next step
Ans is 'a' i.e. MRI "Impacted fractures may be extremely difficult to discern on plain x-ray. If there is a fracture it will show up on MRI or a bone scan after a few days. "- ApleyHistory of fall, leg in externally rotated position and tenderness in Scarpa's triangle highly suggest fracture neck femur.An impacted, undisplaced fracture is likely to miss on an x-ray. An MRI or a bone scan would be needed to diagnose the lesion.
MRI
Repeat X-Ray after one week
Joint Aspiration
Give analgesic and Manipulate
Fracture Neck of Femur