Undiagnosed fractures in severely injured children and young adults. Identification with technetium imaging
| Autor: | Joseph Nadell, Stephen D. Heinrich, Daniel Gallagher, Mitchell Harris |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
Diagnostic Imaging Male medicine.medical_specialty Adolescent medicine.medical_treatment Radiography chemistry.chemical_element Scintigraphy Technetium Fractures Bone medicine Craniocerebral Trauma Humans Internal fixation False Positive Reactions Orthopedics and Sports Medicine Prospective Studies Diagnostic Errors Young adult Child Radionuclide Imaging Reduction (orthopedic surgery) medicine.diagnostic_test Multiple Trauma business.industry Head injury Infant General Medicine medicine.disease Surgery chemistry El Niño Child Preschool Female business |
| Zdroj: | The Journal of Bone & Joint Surgery. 76:561-572 |
| ISSN: | 0021-9355 |
| DOI: | 10.2106/00004623-199404000-00011 |
| Popis: | A whole-body bone scan was performed to search for undetected fractures in forty-eight patients who had multiple injuries or a head injury, or both, and who were less than twenty-two years old. The study took place from January 1991 to July 1992. Radiographs had been made of all areas of suspected skeletal trauma at the time of admission. Follow-up plain radiographs were made of all areas where unexpected abnormal tracer activity was noted. Forty-two of these areas were noted in eighteen skeletally immature patients and fifty-two, in twelve skeletally mature patients. Nineteen previously unrecognized fractures were identified in the subsequent radiographic analysis. Four skeletally immature and two skeletally mature patients had an alteration in treatment on the basis of the identification of a previously undiagnosed injury. Each of these six patients had a cast applied. A fracture was identified three weeks or more after the injury in two skeletally mature patients. These fractures would have been treated (one with a cast and the other with open reduction and internal fixation) if they had been diagnosed earlier. We believe that this analysis demonstrates the usefulness of technetium radionucleotide bone-imaging, as an adjuvant to the orthopaedic examination, in the identification of undiagnosed musculoskeletal injuries in a patient who is less that twenty-two years old and who has sustained a head injury or multiple injuries, or both. |
| Databáze: | OpenAIRE |
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