Occult femoral fracture: Be aware of dual energy computed tomography

J Clin Ultrasound. 2024 Oct;52(8):1254-1258. doi: 10.1002/jcu.23775. Epub 2024 Jul 31.

Abstract

A 74-year-old man was admitted to our emergency department following minor trauma. Plain radiographs and standard computed tomography (CT) scans revealed no signs of fractures. Subsequently, virtual noncalcium (VNCa) images were reconstructed, showing a linear area of bone marrow edema (BME) resembling a femoral neck fracture. Magnetic resonance imaging (MRI) was performed to confirm the presence of BME and an associated intraspongious fracture. In an emergency setting, dual-energy CT (DECT) and VNCa images can successfully identify occult femoral fractures, especially in patients with mild symptoms and minor trauma, thereby preventing misdiagnosis.

Keywords: bone marrow edema; dual‐energy CT; emergency setting; occult femoral fracture; virtual noncalcium.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Femoral Fractures* / diagnostic imaging
  • Fractures, Closed / diagnostic imaging
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Tomography, X-Ray Computed* / methods