A 60-year old female had fallen in the bathroom and she is not able to stand on her feet. On examination, her right leg was in external rotation and was not able to move her leg. There was tenderness in Scarpa's triangle. There is no history of fever. X-ray shows no fracture line. What is the nest step of management
Ans. a. MRI History of fall followed by tenderness in Scarpa's triangle and leg in externally rotated position is suggestive of fracture neck of femur. An impacted, undisplaced fracture is likely to be missed on an X-ray. An MRI or a bone scan would be needed to diagnose the lesion. "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 few days.
MRI
Strict bed rest for 10 days and repeat X-ray
Joint Aspiration
Sta proper anlgesia and sta mobilization to prevent stiffness