MRI for occult physeal fracture detection in children and adolescents

Gufler, Hubert; Schulze, Christian Georg; Wagner, Sabine; Baumbach, Lutz

doi:10.1177/0284185113475606

Cited by 29 publications

(20 citation statements)

References 17 publications

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“…By studying the distribution of the oedema, one can understand the mechanism of injury that occurred and thereby predict with accuracy the associated soft-tissue abnormalities that may be present. [20][21][22] At present, there are few studies describing the role of MRI in traumatic injuries, particularly the soft tissues. Many such studies are localized to a specific part or joint of the body.…”

Section: Resultsmentioning

confidence: 99%

Imaging Patterns in MRI in Recent Bone Injuries Following Negative or Inconclusive Plain Radiographs

Sadineni¹

2015

JCDR

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Section: Resultsmentioning

confidence: 99%

Imaging Patterns in MRI in Recent Bone Injuries Following Negative or Inconclusive Plain Radiographs

Sadineni¹

2015

JCDR

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“…7 studies were prospective and 2 were retrospective. Participants were representative of the target population in all studies, and were described as a consecutive sample in all studies except 1 (Gufler et al 2013), where consecutive recruitment was not reported but was implied. 6 studies included children with suspicion of any ankle fracture and 3 included those with suspicion of distal fibula fracture.…”

Section: Resultsmentioning

confidence: 99%

“…Using different imaging methods such as late radiographs (Simanovsky et al 2005, 2009, Sankar et al 2008, Kan et al 2009) or magnetic resonance imaging (MRI) (Stuart et al 1998, Launay et al 2008, Boutis et al 2010, Endele et al 2012, Gufler et al 2013) as reference standard, numerous studies have looked for the presence of occult fractures in children with radiograph-negative AAI and clinical suspicion of fracture. Some authors have also assessed the accuracy of ultrasound (US) in the detection of occult ankle fractures, comparing it with late radiographs as reference standard (Simanovsky et al 2005, 2009).…”

mentioning

confidence: 99%

Prevalence and clinical significance of occult fractures in children with radiograph-negative acute ankle injury

Najaf-Zadeh

Nectoux²,

Dubos³

et al. 2014

Acta Orthopaedica

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Background and purpose Plain radiographs may fail to reveal an ankle fracture in children because of developmental and anatomical characteristics. In this systematic review and meta- analysis, we estimated the prevalence of occult fractures in children with acute ankle injuries and clinical suspicion of fracture, and assessed the diagnostic accuracy of ultrasound (US) in the detection of occult fractures.Methods We searched the literature and included studies reporting the prevalence of occult fractures in children with acute ankle injuries and clinical suspicion of fracture. Proportion meta-analysis was performed to calculate the pooled prevalence of occult fractures. For each individual study exploring the US diagnostic accuracy, we calculated US operating characteristics.Results 9 studies (involving 187 patients) using magnetic resonance imaging (MRI) (n = 5) or late radiographs (n = 4) as reference standard were included, 2 of which also assessed the diagnostic accuracy of US. Out of the 187 children, 41 were found to have an occult fracture. The pooled prevalence of occult fractures was 24% (95% CI: 18–31). The operating characteristics for detection of occult ankle fractures by US ranged in positive likelihood ratio (LR) from 9 to 20, and in negative LR from 0.04 to 0.08.Interpretation A substantial proportion of fractures may be overlooked on plain radiographs in children with acute ankle injuries and clinical suspicion of fracture. US appears to be a promising method for detection of ankle fractures in such children when plain radiographs are negative.

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“…30 PMMR also has a role in investigation of trauma, not only because of its superior soft tissue contrast resolution but also to assess bone fractures. Clinical scanning with MRI can detect marrow oedema in the absence of a radiologically visible fracture, 31,32 and it is now being used in post-mortem investigation and can be useful to "date" fractures. 33,34 MRI is also particularly appealing for the forensic examination of strangulation in the living, owing to its good soft tissue contrast resolution and lack of radiation exposure.…”

Section: Traumatic Death and Identificationmentioning

confidence: 99%

“…[39][40][41] However, there is a lack of evidence to show that PMCT can do this, showing that the ability of PMCT to detect trauma to the bone, in general, is not enough, as specific injuries such as the characteristic "bucket handle" metaphyseal fractures must be confidently excluded. 42 MRI may be sensitive to these metaphyseal fractures, 31,43 and it is therefore unlikely that CT would be used in living patients owing to radiation exposure.…”

Section: Traumatic Death and Identificationmentioning

confidence: 99%

Adult post-mortem imaging in traumatic and cardiorespiratory death and its relation to clinical radiological imaging

Morgan¹,

Adlam²,

Robinson³

et al. 2014

BJR

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The use of post-mortem imaging is expanding throughout the world with increasing use of advanced imaging techniques, such as contrast-enhanced CT and MRI. The questions asked of post-mortem imaging are complex and can be very different, for example for natural sudden death investigation will focus on the cause, whereas for trauma the cause of death is often clear, but injury patterns may be very revealing in investigating the background to the incident. Postmortem imaging is different to clinical imaging regarding both the appearance of pathology and the information required, but there is much to learn from many years of clinical research in the use of these techniques. Furthermore, it is possible that post-mortem imaging research could be used not only for investigating the cause of death but also as a model to conduct clinically relevant research. This article reviews challenges to the development of post-mortem imaging for trauma, identification and cardiorespiratory death, and how they may be influenced by current clinical thinking and practice.

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MRI for occult physeal fracture detection in children and adolescents

Abstract: The frequency of occult fracture, as detected by MRI, was 34.8%. Thus, MRI is a useful additional imaging method for the detection of occult fractures when radiography is negative.

Cited by 29 publications

References 17 publications

Imaging Patterns in MRI in Recent Bone Injuries Following Negative or Inconclusive Plain Radiographs

Imaging Patterns in MRI in Recent Bone Injuries Following Negative or Inconclusive Plain Radiographs

Prevalence and clinical significance of occult fractures in children with radiograph-negative acute ankle injury

Adult post-mortem imaging in traumatic and cardiorespiratory death and its relation to clinical radiological imaging

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