Missed Fractures

Fractures are commonly missed. To avoid missing them look for:

• The intactness of Shenton’s line

  

  Shenton’s line is an imaginary line drawn up the inferior neck of the femur and extending along the inferior part of the superior pubic ramus. It should be smooth. If it is disrupted, this may indicate a fracture (click on the x-ray to enlarge).

• The line of the trabeculae along the neck of the femur

  

  Follow the trabeculae along the neck of the femur and ensure that they are intact. This x-ray shows an example of a normal trabecular pattern (click on the x-ray to enlarge).

• A sclerotic line across the neck of the femur as this may indicate an impacted fracture

• Steps in the cortex