HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Welling, R. D. Articles by Jebson, P. J. L. Search for Related Content PubMed PubMed Citation Articles by Welling, R. D. Articles by Jebson, P. J. L. Social Bookmarking                      What's this?

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

¹ Department of Radiology, University of Michigan, 1500 E Medical Center Dr., TC-2910L, Ann Arbor, MI 48109-0326.
² Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI.

OBJECTIVE. The purpose of our study was to determine which wrist fractures are not prospectively diagnosed at radiography using CT as a gold standard and to identify specific fracture patterns.

MATERIALS AND METHODS. Through a search of radiology records from January 1 to December 31, 2005, 103 consecutive patients were identified as having radiographic and CT examinations of the wrist. After excluding incomplete or nondiagnostic examinations and those with a greater than 6-week interval between imaging studies, the final study group consisted of 61 wrist examinations in 60 patients. Two musculoskeletal radiologists and one emergency radiologist blindly reviewed CT examinations, and each bone (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate, metacarpals, distal radius, distal ulna) was categorized as normal or fractured, with agreement reached by consensus. Each prospective radiographic report was categorized as either normal or fracture/equivocal for each osseous structure. Results were compared using the chi-square and Fisher's exact tests.

RESULTS. In the proximal carpal row, lunate and triquetrum fractures were often radiographically occult (0% and 20%, respectively, detected at radiography); whereas in the distal carpal row, trapezoid, capitate, and hamate fractures were often occult (0%, 0%, and 40% detected at radiography, respectively). Hamate fractures were significantly associated with metacarpal fractures, and distal radius fractures were associated with scaphoid and ulna fractures.

CONCLUSION. Thirty percent of wrist fractures were not prospectively diagnosed on radiography, suggesting that CT should be considered after a negative radiographic finding if clinically warranted. The location of a dorsal scaphoid avulsion fracture emphasizes the need for specific radiographic views or cross-sectional imaging for diagnosis.

Keywords: CT • fracture • radiography • trauma • wrist

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				Y.-Y. Liao and Y.-M. Lin McNemar Test Is Preferred for Comparison of Diagnostic Techniques Am. J. Roentgenol., October 1, 2008; 191(4): W190 - W190. [Full Text] [PDF]

				E. M. Caoili and J. A. Jacobson Reply Am. J. Roentgenol., October 1, 2008; 191(4): W191 - W191. [Full Text] [PDF]

				R. Kaewlai, L. L. Avery, A. V. Asrani, H. H. Abujudeh, R. Sacknoff, and R. A. Novelline Multidetector CT of Carpal Injuries: Anatomy, Fractures, and Fracture-Dislocations RadioGraphics, October 1, 2008; 28(6): 1771 - 1784. [Abstract] [Full Text] [PDF]