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MRI Beats X-Ray for Spotting Fractures in ER

FRIDAY, March 26 -- X-rays often fail to detect hip and pelvic fractures, a new U.S. study says.

Duke University Medical Center researchers analyzed information on 92 emergency department patients who were given an X-ray and then an MRI to evaluate hip and pelvic pain.

"Thirteen patients with normal X-ray findings were found to collectively have 23 fractures at MRI," the study's lead author, Dr. Charles Spritzer, said in a news release from the American College of Radiology/American Roentgen Ray Society.

In addition, the study found that, "in 11 patients, MRI showed no fracture after X-rays had suggested the presence of a fracture," Spritzer said. "In another 15 patients who had abnormal X-ray findings, MRI depicted 12 additional pelvic fractures not identified on X-rays."

An accurate diagnosis in an emergency department can "speed patients to surgical management, if needed, and reduce the rate of hospital admissions among patients who do not have fractures," he added. "This distinction is important in terms of health-care utilization, overall patient cost and patient inconvenience."

To achieve this, MRI has advantages, the researchers said in their report, in the April issue of the American Journal of Roentgenology.

"Use of MRI in patients with a strong clinical suspicion of traumatic injury but unimpressive X-rays has a substantial advantage in the detection of pelvic and hip fractures, helping to steer patients to appropriate medical and surgical therapy," Spritzer concluded.

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Posted: March 2010