Learning objectives
The aim of this poster is to highlight the most commonly missed fractures in the Emergency Department,
to identify situations that are high risk for an occult fracture and to review the radiographic signs that will reduce the misleading fractures.
Background
In conventional radiology,
missing fractures are a common diagnostic error in emergency.Radiography is the first step for detection of fractures.
The detection of subtle signs of fracture requires a high standard for the acquisition technique and a thorough and systematic interpretation of radiographic images.
Findings and procedure details
1.WRIST
Anatomy
It is known that the carpal bones are divided into two rows: proximal and distal. The proximal carpal row is represented by the scaphoid,
lunate,
triquetrum,
and pisiform while the distal carpal row is comprised of the trapezium,
trapezoid,
capitate,
and hamate.
The distance between carpal bones is less than 3 mm.
Three smooth arches along carpal: a first arch that is a smooth curve outlining the proximal convexities of the scaphoid,
lunate and triquetrum,
a second arch that traces the distal concave...
Conclusion
For theradiologist,good clinical skills are essential in order to avoid subtlefractures.
Awareness of normal anatomic features is crucial in radiologyto be able to detect indirect signs of fracture.
A good and detailed anamnestic history,
focusing on the mechanism of injury should reduce the number of missed fractures.
References
1.
Mohamed Jarraya,1 Daichi Hayashi,1 FrankW.
Roemer; Radiographically Occult and Subtle Fractures: A Pictorial Review;Radiology Research and Practice Volume 2013,
Article ID 370169http://dx.doi.org/10.1155/2013/370169
2.
Blake Reid Boggess,
DO,
FAAFP; Karl B Fields,
MD.
Anatomy and basic biomechanics of the wrist
3.
www.learningradiology.com
4.
www.radiologymasterclass.co.uk
5.
Carol A Boles,
MD; William R Reinus,
MD,
Robert M Krasny,
MD,
Felix S Chew,
MD,
MBA,
Scaphoid Fracture Imaging
6.
Lauren A.
Hackney and Seth D.
Dodds,
Assessment of scaphoid fracture healing.
2011 Mar; 4(1): 16–22
7.
www.radiopaedia.org
8....