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Radiographic changes in algodystrophy of the hand.
D R Bickerstaff1, D P O'Doherty, J A Kanis
1Royal Hallamshire Hospital, Sheffield.
Journal of Hand Surgery (Edinburgh, Scotland)
|February 1, 1991
Summary
Radiographic scoring aids in differentiating post-traumatic algodystrophy from disuse atrophy after Colles' fractures. A new scoring system shows high accuracy for early algodystrophy diagnosis.
Area of Science:
- Orthopedics
- Radiology
- Rheumatology
Background:
- Distinguishing post-traumatic algodystrophy from disuse atrophy on radiographs is challenging.
- Standard radiographic assessment lacks definitive differentiation criteria.
Purpose of the Study:
- To develop and validate a semi-quantitative scoring system for differentiating radiographic features of algodystrophy and disuse atrophy.
- To assess the diagnostic accuracy of the proposed scoring system for early algodystrophy detection.
Main Methods:
- A semi-quantitative scoring system was devised to grade dominant radiographic features in post-traumatic algodystrophy and disuse atrophy.
- The scoring system's intra- and inter-observer reliability was assessed.
- The system was prospectively applied 7 weeks after Colles' fractures.
Main Results:
- The scoring system demonstrated acceptable intra- (14%) and inter-observer (17%) errors.
- Patients with algodystrophy showed significantly higher scores (p < 0.001) compared to those without.
- A score of four or greater identified 87.5% of algodystrophy cases with a positive predictive value of 83%.
Conclusions:
- The developed semi-quantitative scoring system effectively differentiates radiographic features of post-traumatic algodystrophy from disuse atrophy.
- This scoring system shows promise for aiding in the early diagnosis of algodystrophy following Colles' fractures.