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Wrist injuries; diagnosis with multidetector CT.
Martti J Kiuru1, Ville V Haapamaki, Mika P Koivikko
1Department of Radiology, Helsinki University Central Hospital, Töölö Trauma Center, Topeliuksenkatu 5, 00029 Helsinki, Finland.
Emergency Radiology
|August 4, 2004
Summary
Multidetector CT (MDCT) effectively identifies occult wrist fractures and rules out suspected ones, especially in small carpal bones. This imaging provides crucial details for complex wrist injuries when initial radiographs are unclear.
Area of Science:
- Radiology
- Orthopedic Surgery
- Emergency Medicine
Background:
- Wrist injuries are common in emergency room settings.
- Accurate diagnosis of wrist fractures is crucial for appropriate management.
- Traditional radiography may miss subtle or occult fractures.
Purpose of the Study:
- To evaluate the utility of acute-phase multidetector CT (MDCT) in diagnosing wrist injuries.
- To compare MDCT findings with primary radiographs in patients with wrist trauma.
- To assess the role of MDCT in identifying occult fractures and clarifying equivocal radiographic findings.
Main Methods:
- Retrospective review of emergency room MDCT scans for wrist injuries (August 2000 - May 2003).
- Inclusion of 38 patients who underwent initial MDCT for wrist injury.
- Analysis of MDCT findings in relation to injury mechanism, fracture location, and type, with comparison to primary radiographs.
Main Results:
- MDCT identified 56 fractures and 7 dislocations in 29 patients.
- MDCT revealed 9 occult fractures, primarily in carpal bones, missed by initial radiographs.
- MDCT ruled out suspected fractures in 14 cases, improving diagnostic accuracy.
Conclusions:
- MDCT is a valuable tool for assessing acute wrist injuries, particularly complex fractures.
- MDCT offers superior detection of occult fractures and clarification of equivocal findings compared to radiography.
- High-quality reformatted images from MDCT provide detailed fracture anatomy information.