# Occult Intertrochanteric Fracture Detected by Bone Scan Imaging: A Case Report

## TL;DR

A bone scan successfully detected a hidden hip fracture in an elderly patient when other imaging methods failed.

## Contribution

Demonstrates the utility of bone scans in diagnosing occult intertrochanteric fractures when MRI or CT is unavailable or unsuccessful.

## Key findings

- Radiographs and CT scans failed to detect the intertrochanteric fracture in a 91-year-old patient.
- A bone scan identified the fracture, highlighting its role in challenging diagnostic cases.
- Bone scans can be a viable alternative when MRI or CT is not feasible.

## Abstract

Femoral intertrochanteric fractures can be occult and not visible on plain radiographs, even when there is a high clinical suspicion. This case study reports an occult intertrochanteric fracture that was diagnosed using a bone scan rather than an MRI or CT scan.

A 91-year-old woman arrived at the emergency room with a complaint of left hip pain after slipping at home. Clinical examination revealed tenderness, mild swelling, limited range of motion, and an inability to bear weight. Radiographs and CT scans of the hip and pelvis showed no evidence of a fracture. An MRI was planned, but the patient's agitation resulted in improper images. Consequently, a bone scan identified an ill-defined focal area with slightly increased activity, consistent with an intertrochanteric femur fracture. In such challenging scenarios, bone scans can still serve as an alternative diagnostic tool, aiding in clinical decision-making.