Detection of traumatic elbow arthrotomies: computed tomography scan vs. saline load test
| Autor: | Alfred M. Faulkner, Matthew J. Yousif, Tyler D. Kupchick, Alexander J. Colen, Blake R. Fenkell |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Elbow Computed tomography Sodium Chloride computer.software_genre Sensitivity and Specificity Injections Intra-Articular 03 medical and health sciences Load testing 0302 clinical medicine Elbow Joint Cadaver Medicine Humans Orthopedics and Sports Medicine Coloring Agents Saline Arthrotomy 030222 orthopedics medicine.diagnostic_test business.industry 030229 sport sciences General Medicine medicine.disease Methylene Blue medicine.anatomical_structure Orthopedic surgery Surgery Septic arthritis business Cadaveric spasm Nuclear medicine Tomography X-Ray Computed Elbow Injuries computer Joint Capsule Extravasation of Diagnostic and Therapeutic Materials |
| Zdroj: | Journal of shoulder and elbow surgery. 29(9) |
| ISSN: | 1532-6500 |
| Popis: | Background Traumatic elbow arthrotomies are common injuries evaluated for by orthopedic services; however, failed identification of a traumatic arthrotomy leads to a high risk of developing septic arthritis. Currently these injuries are evaluated by either a saline load test or a computed tomography (CT) scan, yet there is little published evidence regarding detection of traumatic elbow arthrotomies. Hypothesis In our study, we hypothesized better sensitivity and specificity of detecting a traumatic elbow arthrotomy with a CT scan over a saline load test. Study Design Descriptive cadaveric laboratory study. Methods Ten fresh-frozen cadaveric transhumeral upper extremity amputation specimens were thawed for trial. Specimens were brought through CT scan prior to arthrotomy, arthrotomy was made, and then post arthrotomy a repeat CT scan was performed. A saline load test was then performed after all CT scans were completed. Results Zero CT scans before (0/10) and after (0/10) the arthrotomies were positive for intra-articular air in the elbow joint with a 0% sensitivity and specificity. The saline load test had an average positive test at 19 mL with a 100% sensitivity and 100% specificity. Conclusion After our study and based on the recommendations of the brief literature on this topic, we advise evaluating for traumatic elbow arthrotomies with a saline load test as the primary method of detection. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect