Are oblique views needed for trauma radiography of the distal extremities?

Smet, Arthur A. De; Doherty, Megan; Norris, Mireille; Hollister, Mark C.; Smith, David L.

doi:10.2214/ajr.172.6.10350289

Cited by 36 publications

(22 citation statements)

References 8 publications

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“…22 The American College of Radiology, ACR Appropriateness criteria for hand and wrist trauma suggest including at least posteroanterior, lateral, and externally rotated views for a suspected fracture or dislocation. 23 In a prospective study, De Smet et al 24 investigated the value of oblique radiographic views in evaluating trauma to the fingers and toes. Among 1,461 radiographic examinations, 219 (15%) were of the hands.…”

Section: Discussionmentioning

confidence: 99%

Fractures of the Fingers Missed or Misdiagnosed on Poorly Positioned or Poorly Taken Radiographs: A Retrospective Study

Tunçer

Aksu

Dilek

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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Section: Discussionmentioning

confidence: 99%

Fractures of the Fingers Missed or Misdiagnosed on Poorly Positioned or Poorly Taken Radiographs: A Retrospective Study

Tunçer

Aksu

Dilek

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…In suspected fracture or joint injury, the initial imaging modality is plain radiography with anterior-posterior and lateral views, and consideration of an oblique view for overlapping bones. 37 Hand radiographs should be evaluated for adequacy of views, bony alignment, and individual bone morphology. In the posterior-anterior view of a normal hand, the middle metacarpal axis and radius axis should line up with one another, and the ulnar styloid should project laterally from the distal ulna.…”

Section: Imaging Studiesmentioning

confidence: 99%

Evaluation of Knowledge of Emergency Physicians Regarding Assessment and Initial Management of Hand Injuries

Fareed¹,

Dasgupta²,

Maiti³

et al. 2020

IJAR

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Int. J. Adv. Res. 8(03), 268-309 269 and 107(71.3%) emergency physicians were Male. Questions on the Haemorrhage Control, Fight Bites, Burns, Nerve Examination, Fractures, Tendon Injury, Radiology and local anaesthesia were answered correctly by most of the emergency physicians, but there was significant knowledge deficit in the questions based on Amputation , Nail bed injury and High pressure injection injury. Overall ,our study shows that there is significant knowledge deficit amongst the emergency physicians ,out of the twenty questions on various hand injuries presenting to ED,10(6.7%) emergency physicians had 100% correct answers, 35(23.3%) emergency physicians had 50% correct answers and 105(70.0%) emergency physicians had below 50% correct answers.Hence this study showed significant knowledge deficit in assessment and management of hand injuries amongst Emergency Physicians.Copy Right, IJAR, 2020,. All rights reserved. …………………………………………………………………………………………………….... Introduction:-Human alone through the course of evolution has a hand,he used as a tool, symbol, and as a weapon. Any grievous injury to such a vital organ can be a huge occupational and socio-economic burden. Acute traumatic injuries of the hand and wrist especially from road traffic accidents are often encountered in the emergency department. About 10 to 20% of the patients attending the emergency and trauma care present with various forms of hand injuries. Several studies have enumerated the injuries to hand as per the severity where the most common being the soft tissue injuries followed by open wound injuries. The injuries to deeper structures like vessels, nerve and underlying bones were less common. 1, 2, 3 . So for the optimum treatment of any serious hand injury depends upon early recognition and appropriate referral. This can only be achieved with a thorough understanding about the evaluation and management of hand injuries by the ED physicians.Function of hand has to be optimal for good quality of life. Unfortunately, hand injuries are very common as finger and hand injuries are the most common type of work related injury 4 . Severe and life threatening hand injuries are generally managed in the hospital emergency department setting. Whereas if the injuries are not that severe,they can be successfully managed in primary care. Many of the studies have enumerated the injuries to hand as per the severity where the most common being the soft tissue injuries followed by open wound injuries. The causes of such hand injuries are numerous and can include traumatic injuries, sporting accidents, occupational injuries, burns (thermal and chemical) and bites of various types. This study emphasises on the knowledge of emergency physicians regarding initial management and assessment of hand injuries presenting to emergency department followed by more specific detail about common injuries and their management. The aim is not to cover each injury in detail, but to assess the knowledge of emergency physicians regarding hand injuries and how confidently ...

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“…Initial imaging typically consists of a 3-view study, with the possibility of additional views as indicated by the clinical setting [11]. CT is commonly used in evaluating the true extent of osseous injury in complex fractures, and at times is used as the initial medical imaging study in polytrauma patients, and in complex regions, such as the midfoot [12][13][14].…”

Section: Overview Of Imaging Modalitiesmentioning

confidence: 99%

ACR Appropriateness Criteria Acute Trauma to the Foot

Bancroft¹,

Kransdorf

Adler³

et al. 2015

Journal of the American College of Radiology

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This ACR Appropriateness Criteria article offers imaging triage guidance for several variants of patients presenting with acute foot trauma. Patients meeting inclusion criteria for the Ottawa Rules should undergo a 3-view radiographic series. Diabetic patients with peripheral neuropathy should undergo radiography, even though they do not meet the Ottawa Rules inclusion criteria. Patients with suspected midfoot and/or Lisfranc injury should undergo 3-view radiographs with weight bearing on at least the anterior-posterior view. Patients with suspected Lisfranc injury and normal radiographs should be considered for MRI and CT on a case-by-case basis. MRI or ultrasound could confirm cases of suspected acute tendon rupture. Radiography is the initial imaging modality for suspected plantar plate injury after metatarsal-phalangeal joint injury. Weight-bearing anterior-posterior, lateral, and sesamoid axial views may detect proximal migration of the hallux sesamoids. Ultrasound or MRI can directly evaluate the capsuloligamentous complex, specifically the plantar plate. Radiography can detect radiopaque penetrating foreign bodies, and ultrasound can be helpful in detecting those that are nonradiopaque. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures, by the panel. In instances in which evidence is lacking or is not definitive, expert opinion may be used to recommend imaging and treatment.

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Are oblique views needed for trauma radiography of the distal extremities?

Cited by 36 publications

References 8 publications

Fractures of the Fingers Missed or Misdiagnosed on Poorly Positioned or Poorly Taken Radiographs: A Retrospective Study

Fractures of the Fingers Missed or Misdiagnosed on Poorly Positioned or Poorly Taken Radiographs: A Retrospective Study

Evaluation of Knowledge of Emergency Physicians Regarding Assessment and Initial Management of Hand Injuries

ACR Appropriateness Criteria Acute Trauma to the Foot

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