How are pelvic fractures diagnosed?
In the case of major injuries, such as road traffic accidents, where pelvic fracture is likely and must be excluded, X-rays will be performed urgently to assess the state of the pelvic bones. A pelvic fracture is also suspected if you have had a lesser injury but there is pelvic bone tenderness, difficulty walking or any loss of sensation in the lower part of the body.
X-ray will show most pelvic bone injuries, although it will not show details of injuries to organs inside the pelvis. X-rays provide images of bones and in the case of the pelvis, they are usually taken from a number of different angles, so that doctors can check whether (and how much) the bones are out of line.
A computed tomography (CT) scan involves multiple X-rays in 'slices' down through the pelvis in order to build up a three-dimensional image of the injuries. This will be done in complicated cases to get a better picture of the fractures and to look for associated injuries.
A magnetic resonance image (MRI) scan is an alternative to CT and may give a clearer picture of damage. This is not usually necessary, except in the case of stress fractures, which can show up well on MRI scanning but which commonly are not visible on X-ray or CT.
Ultrasound scans and contrast studies (where a radioactive dye is injected to create pictures to enable doctors to check on internal organs and structures) may be needed to assess internal organs.
Radioisotope bone scans are sometimes used to look for stress fractures, particularly in patients who cannot have an MRI scan (for example, if they have a pacemaker).
If your fracture happened unusually easily, and your doctor thinks there is a possibility that you have underlying 'thinning' of the bones (osteoporosis), you may be offered a bone scan to check your bone density. This scan is called dual-energy X-ray absorptiometry (DXA - formerly DEXA).
Other investigations may include blood tests to assess the degree of blood loss and the function of the liver and kidneys, and testing of the urine to look for damage to the bladder.
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