Intertrochanteric femur fracture - spectral CT

Case contributed by Suresh Babu Boddapati
Diagnosis certain

Presentation

Right hip pain after fall.

Patient Data

Age: 60 years
Gender: Female

Pelvis and right hip

x-ray
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Info

No fracture or dislocation.

This study is a stack
Coronal Calcium
supression
This study is a stack
Coronal
bone window
This study is a stack
Axial bone
window
This study is a stack
Axial
non-contrast
This study is a stack
Sagittal
bone window
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Bone marrow oedema in the right intertrochanteric region is seen on calcium suppression images.

Subtle sclerosis in the intertrochanteric region is seen on coronal bone window images. No cortical breach was seen. Compare with the opposite site.

This study is a stack
Coronal
T1
This study is a stack
Coronal
STIR
This study is a stack
Axial
STIR
This study is a stack
Coronal
STIR
This study is a stack
Sagittal
STIR
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Info

Intertrochanteric fracture line seen on T1 with fluid and oedema on STIR images.

Case Discussion

Calcium suppression images showing bone marrow oedema are useful in detecting occult nondisplaced acute fractures.

This is a useful application of spectral/dual energy CT.

MRI helped in confirming the diagnosis.

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