[Clinical impact of MRI in acute wrist injuries. Indication and therapeutic consequences]
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1Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Frankfurt/Main.
Purpose:
This prospective study was aimed at evaluating the clinical impact of magnetic resonance imaging (MRI) vs conventional radiographs in the early diagnosis of acute wrist fractures. The influence of MRI on the period of being unable to work was demonstrated.
Materials And Methods:
MRI was performed within a mean of 6.6 days after initial radiographs in 54 patients (56 wrists) with clinical suspicion of wrist fractures and normal plain or indistinct radiographs. MRI findings were read without knowledge of the initial radiographs.
Results:
In 31 of 56 wrists MRI findings resulted in a change of diagnosis. There was a false positive diagnosis on plain radiographs in nearly one-half ( n=25) of the cases,whereas only six cases had false negative results. In 28 cases MRI allowed the detection of additional injuries of soft tissues. In 35 of 56 cases radiological follow-up was no longer necessary. In 22 of 54 patients the period of immobilization could be shortened or treatment discontinued ( n=18). The period of being unable to work was shortened in 16 of 54 patients, while in 7 of 54 patients this time span had to be prolonged for therapeutic reasons. In 31 of 54 patients MRI-based therapeutic consequences had no influence on the period of being unable to work.
Conclusion:
Our results show a high clinical impact of MRI in the detection of acute wrist fractures. Early MRI is able to reduce economic costs due to efficient therapeutic treatment and shortened periods of being unable to work. We recommend MRI immediately on the day of trauma in the presence of clinical suspicion and equivocal plain radiographs
Insights
Magnetic resonance imaging (MRI) significantly improves early diagnosis of acute wrist fractures compared to conventional radiographs. This can lead to reduced immobilization and shorter periods of being unable to work, optimizing patient recovery and economic outcomes.
Area of Science:
- Radiology
- Orthopedic Surgery
- Medical Imaging
Context:
- Acute wrist fractures are common injuries.
- Conventional radiographs are the initial diagnostic tool.
- Subtle or indistinct fractures can be missed on plain radiographs.
Purpose:
- To evaluate the clinical impact of magnetic resonance imaging (MRI) versus conventional radiographs in diagnosing acute wrist fractures.
- To assess the influence of MRI on patient recovery time and ability to work.
Summary:
- This prospective study involved 54 patients with suspected wrist fractures and normal or indistinct radiographs.
- MRI was performed after initial radiographs, with findings interpreted independently.
- MRI led to diagnostic changes in over half of the cases and identified additional soft tissue injuries.
Impact:
- MRI significantly altered diagnoses and identified additional injuries, reducing the need for further radiological follow-up.
- Early MRI enabled shortened immobilization periods and treatment discontinuation in numerous patients.
- The study highlights MRI's potential to reduce economic costs through efficient treatment and decreased work absence.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...