Fulltext

Occult fractures of the scaphoid: the role of ultrasonography in the emergency department

Platon, Alexandra ; Poletti, Pierre-Alexandre ; Van Aaken, Jan ; Fusetti, Cesare ; Della Santa, Dominique ; Beaulieu, Jean-Yves ; Becker, Christoph

In: Skeletal Radiology, 2011, vol. 40, no. 7, p. 869-875

Ajouter à la liste personnelle
    Titre
    • Occult fractures of the scaphoid: the role of ultrasonography in the emergency department
    Auteur
    • Platon, Alexandra. Department of Radiology, University Hospital of Geneva, 4, rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
    • Poletti, Pierre-Alexandre. Department of Radiology, University Hospital of Geneva, 4, rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
    • Van Aaken, Jan. Hand Surgery Unit, Department of Orthopaedics and Traumatology, University Hospital of Geneva, Geneva, Switzerland
    • Fusetti, Cesare. Hand Surgery Unit, Department of Orthopaedics and Traumatology, Ospedale San Giovanni, Bellinzona, Switzerland
    • Della Santa, Dominique. Hand Surgery Unit, Department of Orthopaedics and Traumatology, University Hospital of Geneva, Geneva, Switzerland
    • Beaulieu, Jean-Yves. Hand Surgery Unit, Department of Orthopaedics and Traumatology, University Hospital of Geneva, Geneva, Switzerland
    • Becker, Christoph. Department of Radiology, University Hospital of Geneva, 4, rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:320767
    Summary
    Objective: To evaluate ultrasonography (US) performed by an emergency radiologist in patients with clinical suspicion of scaphoid fracture and normal radiographs. Materials and methods: Sixty-two consecutive adult patients admitted to our emergency department with clinical suspicion of scaphoid fracture and normal radiographs underwent US examination of the scaphoid prior to wrist computed tomography (CT), within 3days following wrist trauma. US examination was performed by a board-certified emergency radiologist, non-specialized in musculoskeletal imaging, using the linear probe (5-13MHz) of the standard sonographic equipment of the emergency department. The radiologist evaluate for the presence of a cortical interruption of the scaphoid along with a radio-carpal or scapho-trapezium-trapezoid effusion. A CT of the wrist (reference standard) was performed in every patient, immediately after ultrasonography. Fractures were classified into two groups according to their potential for complication: group 1 (high potential, proximal or waist), group 2 (low-potential, distal or tubercle). Results: A scaphoid fracture was demonstrated by CT in 13 (21%) patients: eight (62%) of them belonged to group 1 (three in the proximal pole, five in the waist), five (38%) to group 2 (three in the distal part, two in the tubercle). US was 92% sensitive (12/13) in demonstrating a scaphoid fracture. It was 100% sensitive (8/8) in demonstrating a fracture with a high potential of complication (group 1). Conclusions: Our data show that, in emergency settings, US can be used for the triage to CT in patients with clinical suspicion of scaphoid fracture and normal radiographs