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The clinical presentation of occult hip fractures and fractures of the anterior pelvic ring are often similar.1,2 Differentiating these two diagnoses by routine roentgenographic examinations (ie, MRI, bone scan, tomograms)1"4 can be costly and time consuming. A pelvic inlet view (a radiograph with the x-ray beam directed 45° caudally) provides an inexpensive diagnostic alternative to these more involved radiographic examinations. We present two representative cases from a series of six in which the inlet view was helpful in identifying a minimally displaced anterior pelvic ring fracture as the cause for groin pain.
CASE REPORTS
Case 1. A 50-year-old man complained of right groin pain following a bicycle accident. His groin pain was present only with weight bearing. Examination demonstrated full range of painless right hip motion. Neither percussion of his heel with his knee in extension nor percussion over the tibial tubercle of his flexed knee elicited pain. Hip and anteroposterior (AP) pelvis radiographs were interpreted as normal. Inlet/outlet views of his pelvis revealed a minimally displaced ischial ramus fracture (Figs IA-B). He was discharged home with instructions for graduated weight bearing as tolerated. His fracture healed uneventfully. Nine months after the incident, he was riding his bike nearly 18 miles each day.
Case 2. An 83-year-oJd woman complained of left groin pain of 2 weeks' duration. Seven months previously, a cemented, bipolar endoprosthesis was implanted as treatment for a completely displaced left femoral neck fracture. She denied recent...