Hip Fracture | Testing & Diagnosis

How do you diagnose a broken hip?

At Boston Children's Hospital, we know that the first step in treating your child’s broken hip is to form an accurate and complete diagnosis.

During a physical exam, the doctor obtains a complete medical history of your child and asks how your child got hurt. The physician will look for any injuries commonly associated with hip fractures. These can include injury to any of the structures housed by the pelvic bones, such as the lower portion of the intestines and rectum, the urinary bladder and the reproductive organs. Other commonly associated injuries include head injuries and additional fractures.

The doctor will examine any lacerations to determine whether an open fracture (bone visible through the skin) has occurred, and will press on front and back of the pelvic area to help determine how stable the hip is. A rectal examination also may be performed to look for hemorrhage that may signify bone penetration into the rectum.

Diagnostic testing for a broken hip

  • X-ray: uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film — usually sufficient for the majority of fractures
  • MRI (Magnetic Resonance Imaging): uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body; especially useful for assessing soft tissue around injured joints and bones
  • Computed tomography scan (CT, CAT scan): uses a combination of x-rays and computer technology to produce 3-D cross-sectional images (slices), both horizontally and vertically, of the affected area — including bones, fat, soft tissue
  • Bone scan: uses a radioactive dye to visualize the bones. It’s different from plain x-rays or CT in that it shows bone metabolism and cell activity in the bones. Bone scans are used to assess bone growth activity, bone remodeling activity and/or blood flow in the affected area(s).