injuries poisoning
Pelvic Fractures
Diagnosis of Pelvic Fractures
Plain x-rays Usually noncontrast CT Pelvic fractures should be considered if patients have pain in the pelvic region or hip or have had major trauma. An anteroposterior pelvis x-ray shows most fractures. A displaced fracture indicates that the pelvic ring is disrupted, suggesting another fracture or syndesmotic or ligamentous disruption. Specialized x-ray views (eg, Judet views to visualize the acetabulum) may be necessary. CT is more sensitive than x-rays and is usually done to identify all fracture fragments and certain associated injuries when the fracture is due to a high-energy injury. CT is often unnecessary when patients have an isolated pubic ramus fracture due to a low-energy injury or a small avulsion fracture. Diagnosis and treatment of associated injuries takes precedence over full definition of the pelvic fracture. Bladder Trauma should be considered and evaluated. Tests include Urinalysis to check for hematuria Neurologic examination Pelvic examination in women to check for vaginal injury Retrograde urethrography to check for urethral injury, if indicated Traditionally, digital rectal examination is done in men to check for a high-riding prostate, which suggests increased risk of posterior urethral injury. However, the usefulness of this examination is not clear. If Urethral Trauma is suspected (eg, because blood is seen at the meatus), retrograde urethrography should be done. 