Multidetector computed tomography (MDCT) is a highly valuable imaging tool for the diagnosis of
occult fractures. CT has several advantages including short acquisition time (compared to MRI), the ability to acquire volumetric and isotropic image data sets, the opportunity to reconstruct multiplanar reformations in any arbitrary plane, and excellent spatial resolution [9].
* Covert or
occult fractures that are not easily detected by preliminary x-rays.
MRI showed a low intensity lesion in the T1-weighted image (b) with a high intensity change in the T2-STIR image (c) indicating an
occult fracture at the L4 vertebral body (arrowheads).
Occult fractures of the greater tuberosity of the humerus: radiographic and MR imaging findings.
Magnetic resonance (MR) imaging is used to detect radiographically
occult fractures common in elderly osteoporosis patients.
As always, consider the unusual--such as
occult fractures or osteochondritis--if ankle injuries aren't improving as expected.
MRI is better able to visualize radiographically
occult fractures as well as surrounding soft tissue abnormalities and edema in the pediatric patient following trauma (Figure 9).
Dorsay and associates (18) showed that MR imaging might be cost effective in the diagnosis of
occult fractures as well.
Occult fractures may be suspected due to clinical indications but cannot initially be demonstrated radiographically.
Nevertheless, we feel that, despite its more limited interobserver reliability, the fracture portion of the score should be preserved in our proforma as radiographically
occult fractures are a hallmark of the pathogenesis of the active Charcot foot [10, 12].
