MDCT and Radiography of Wrist Fractures: Radiographic Sensitivity and Fracture Patterns

Welling, Rodney D.; Jacobson, Jon A.; Jamadar, David A.; Chong, Suzanne T.; Caoili, Elaine M.; Jebson, Peter J.L.

doi:10.2214/ajr.07.2699

Cited by 145 publications

(87 citation statements)

References 22 publications

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“…Therefore, it can be assumed that early diagnosis and treatment planning cannot be assured if diagnosis relies on biplane radiography only. This is in concordance with recent reports supporting MDCT as a diagnostic modality of high diagnostic accuracy in scaphoid fracture detection [23][24][25][26] whereas in these reports radiography also was of limited value [23,25,27] . Stevenson et al [24] showed that using initial MDCT an occult scaphoid fracture can be ruled out with the patient returning to regular activity immediately.…”

Section: Resultssupporting

confidence: 92%

Comparison of conventional radiography and MDCT in suspected scaphoid fractures

Behzadi

Karul

Henes

et al. 2015

WJR

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AIM:To determine the diagnostic accuracy and radiation dose of conventional radiography and multidetector computed tomography (MDCT) in suspected scaphoid fractures. METHODS:One hundred twenty-four consecutive patients were enrolled in our study who had suffered from a wrist trauma and showed typical clinical symptoms suspicious of an acute scaphoid fracture. All patients had initially undergone conventional radiography. Subsequent MDCT was performed within 10 d because of persisting clinical symptoms. Using the MDCT data as the reference standard, a fourfold table was used to classify the test results. The effective dose and impaired energy were assessed in order to compare the radiation burden of the two techniques. The Wilcoxon test was performed to compare the two diagnostic modalities. RESULTS:Conventional radiography showed 34 acute fractures of the scaphoid in 124 patients (42.2%). Subsequent MDCT revealed a total of 42 scaphoid fractures. The sensitivity of conventional radiography for scaphoid fracture detection was 42.8% and its specificity was 80% resulting in an overall accuracy of 59.6%. Conventional radiography was significantly inferior to MDCT (P < 0.01) concerning scaphoid

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Section: Resultssupporting

confidence: 92%

Comparison of conventional radiography and MDCT in suspected scaphoid fractures

Behzadi

Karul

Henes

et al. 2015

WJR

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“…A previous report found that only 20% of triquetrum fractures were identified on plain radiographs [10]. Given the morbidity associated with non-union of triquetrum body fractures, we advocate a high index of suspicion for these fractures in people who have fallen on an outstretched hand, and present with ulnar-sided wrist pain.…”

Section: Discussionmentioning

confidence: 85%

Non-union of Isolated Displaced Triquetral Body Fracture- A Case Report

Rashid

Rasoli²,

Khan³

2012

Ortopedia, traumatologia, rehabilitacja

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SUMMARYTriquetral fractures are the second most common carpal fractures. Triquetral body fractures are the less common type of triquetral fractures but they can be missed on plain radiographs and a non-union can be associated with considerable morbidity and reduction in functional activities. We report a unique case of displaced isolated triquetral body fracture that was initially missed on plain radiographs and resulted in non-union. The fracture non-union was diagnosed on magnetic resonance imaging and was treated successfully with open reduction and internal fixation using compression screws, without bone grafting, and early mobilisation of the wrist allowing a return to premorbid activity levels. To our knowledge, this has not been previously described in the literature. We advocate early clinical suspicion of triquetral fractures in patients with persistent ulnar-sided wrist pain following trauma, and early evaluation using computed tomography or magnetic resonance imaging.

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“…Bununla beraber, büyük bir hasta sayısının oldugu bazı çalışmalar göstermiştir ki, konvansiyonel radyografi karpal kırıkların tespitinde yetersiz kalmaktadır (8,9) . Tomografinin el bileğindeki kırıkların tespitinde tatmin edici duyarlılığa sahip oldugu da çalışmalarda belirtilmiştir (10) .…”

Section: Discussionunclassified