Can we 'Hear' Femoral Neck Fractures? Ultrasound Guided Diagnosis of Femoral Neck Fractures

Hip (femoral neck and pertrochanteric) fractures account for a significant part of Emergency Department (ED) visits after trauma. Studies suggest that point-of-care ultrasound (POCUS) is a reliable diagnostic tool for fracture assessment. POCUS has several advantages over conventional radiography, such as being portable, cheaper and radiation free. In addition, immediate conversion to ultrasound guided regional anaesthesia upon diagnosis of fracture can improve patient's time to proper analgesia. Moreover, POCUS can potentially be used pre-hospital to rule out hip fractures reducing ED crowding, as well as being a solution for areas where radiography is not readily available (e.g. rural or developing areas). The primary objective of this study, is to evaluate the diagnostic capabilities of POCUS regarding patients with suspected hip fracture after trauma compared to radiography, the current standard of care diagnostic tool.

Inclusion Criteria: * ≥18 years of age * presenting to the ED with a painful hip after trauma, suspected of hip fracture as defined by the attending clinician Exclusion Criteria: * History of hip fracture or surgical procedure on the bones of the ipsilateral hip (ultrasound images may be unreliable) * Presence of foreign body material in the ipsilateral hip * Skin defects at the POCUS site e.g. lacerations, infected skin * Extensive injuries, extreme pain or neurovascular damage where urgent intervention is required * Inability to give informed consent (cognitive impairments, no proficient understanding of the Dutch or English language)