Hip Fracture, Xray negative, what’s next?

I usually review a question on my board review series regarding a patient with trauma and negative x-ray of hip, what is the next step? The answer is usually CT scan, and I have to admit that this is my routine practice that I do not rely on X-ray, if my patient still is symptomatic,

I will do confirmatory test and that is usually CT. It is faster and easier to be done in ED,  but Injury published this study in May, 2015  observed that MRI has a higher diagnostic accuracy than CT in detecting occult fractures of the hip, Just for resident who needs resource for our board review discussion.

 

Link to article