How is a hip fracture primarily diagnosed?

• A. By clinical assessment alone.
• B. By MRI only.
• C. By CT scan as the initial test.
• D. By clinical assessment and confirmed with X-ray imaging.

Answer: (D)

A hip fracture is diagnosed primarily through a combination of clinical assessment and radiographic confirmation. Clinically, patients often have hip or groin pain after a fall, are unable to bear weight, and may hold the leg in a shortened, externally rotated position. Plain X-ray imaging of the hip and pelvis is the initial test because it quickly confirms most fractures, shows the exact location (femoral neck versus intertrochanteric), and helps guide treatment decisions.

If the X-ray is negative but clinical suspicion remains high, MRI is the preferred next step because it is the most sensitive test for occult fractures. CT can be used when MRI is unavailable or to better define fracture details for surgical planning. In short, start with clinical assessment and confirm with X-ray imaging.