title: Occult Intertrochanteric Fracture Mimicking the Fracture of Greater Trochanter.
abstract: OBJECTIVE
  Occult intertrochanteric fractures are misdiagnosed as isolated greater trochanteric fractures in some cases. We investigated the utility of three-dimensional computed tomography (3D-CT) and magnetic resonance imaging (MRI) in the diagnosis and outcome management of occult intertrochanteric fractures.
  
  
  METHODS
  This study involved 23 cases of greater trochanteric fractures as diagnosed using plain radiographs from January 2004 to July 2013. Until January 2008, 9 cases were examined with 3D-CT only, while 14 cases were screened with both 3D-CT and MRI scans. We analyzed diagnostic accuracy and treatment results following 3D-CT and MRI scanning.
  
  
  RESULTS
  Nine cases that underwent 3D-CT only were diagnosed with isolated greater trochanteric fractures without occult intertrochanteric fractures. Of these, a patient with displacement received surgical treatment. Of the 14 patients screened using both CT and MRI, 13 were diagnosed with occult intertrochanteric fractures. Of these, 11 were treated with surgical intervention and 2 with conservative management.
  
  
  CONCLUSIONS
  Three-dimensional CT has very low diagnostic accuracy in diagnosing occult intertrochanteric fractures. For this reason, MRI is recommended to confirm a suspected occult intertrochanteric fracture and to determine the most appropriate mode of treatment.
authors.affiliation: Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: Phil Hyun
authors.initials: PH
authors.lastname: Chung
authors.affiliation: Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: Suk
authors.initials: S
authors.lastname: Kang
authors.affiliation: Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: Jong Pil
authors.initials: JP
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: Young Sung
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: Ho Min
authors.initials: HM
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: In Hwa
authors.initials: IH
authors.lastname: Back
authors.affiliation: Department of Orthopedic Surgery, Dongguk University College of Medicine, Gyeongju, Korea.
authors.forename: Kyeong Soo
authors.initials: KS
authors.lastname: Eom
keywords: Computed tomography; Femur; Intertrochanteric fracture; Magnetic resonance imaging; Occult fracture