Utilisation of plain film and theatre radiography in the diagnosis and treatment of neck of femur fracture in an elderly woman in Zambia

Abstract

Neck of femur (NOF) fractures are a common reason for referral to the radiology department, especially in elderly patients, with plain radiography being the first-line imaging modality for diagnosis. This imaging case report discusses an 85-year-old woman who presented with right hip pain following a fall and was diagnosed with a fractured NOF. She underwent hip hemiarthroplasty and, at a 3-month follow-up, had nearly regained her pre-fracture walking ability. The case highlights the importance of trauma and theatre radiography as specialised areas within diagnostic imaging, requiring technique adjustments due to the limited mobility and cooperation of trauma patients. Standard imaging for suspected NOF fractures should include an anteroposterior (AP) view of the pelvis and a horizontal beam lateral view of the affected hip to allow comparison of both hips, rule out additional injuries in the pelvis region, assess fracture displacement and comminution, and aid in pre-operative hip planning. Post-operative radiographs should also include both hips to evaluate implant positioning, alignment, and potential complications. In this imaging case report, variations in imaging were noted due to the lack of established protocols for trauma and theatre radiography at our radiology department, highlighting the need for standardised guidelines in these settings.