The value of soft tissue signs in wrist trauma

Zammit-Maempel, I; Bisset, R.A.L.; Morris, Julie; Forbes, W S

doi:10.1016/s0009-9260(88)80089-8

Cited by 16 publications

(15 citation statements)

References 5 publications

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“…Although subsequent studies did not always report high sensitivity of the radiographic abnormality of the pronator fat stripe in fractures around the wrist joint, 6 , 7 some results supported the diagnostic importance of this muscle. Sasaki and Sugioka 8 classified the radiologic appearance of the pronator quadratus into 4 types and reported that 85% of the pronator quadratus muscles of undisplaced extra‐articular distal radius fractures were displaced anteriorly and formed an irregular or interrupted line.…”

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confidence: 95%

“…Sasaki and Sugioka 8 classified the radiologic appearance of the pronator quadratus into 4 types and reported that 85% of the pronator quadratus muscles of undisplaced extra‐articular distal radius fractures were displaced anteriorly and formed an irregular or interrupted line. Zammit‐Maempel et al 6 reported fractures of the distal radius and ulna, and the distal radius had a significantly greater distance from the pronator fat line on lateral radiographs, and they also reported that only 51% of forearm fractures showed an abnormal pronator fat stripe.…”

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confidence: 99%

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Sonographic Appearance of the Pronator Quadratus Muscle in Healthy Volunteers

Sato¹,

Ishii²,

Noguchi³

et al. 2014

J of Ultrasound Medicine

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confidence: 95%

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confidence: 99%

Sonographic Appearance of the Pronator Quadratus Muscle in Healthy Volunteers

Sato¹,

Ishii²,

Noguchi³

et al. 2014

J of Ultrasound Medicine

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“…The pronator value as described by Zammit-Maempell et al [4] ranged from 8 to 11.5 mm in 17/28 cases. This value was higher in injuries with bone bruising or occult fracture compared to soft-tissue injury or joint effusion.…”

Section: Resultsmentioning

confidence: 99%

“…Zammit-Maempell et al [4] measured the pronator value (maximum distance between the pronator fat line and the distal radius) in 1,453 patients with wrist injury and reported a statistically significant increased pronator value in fractures of the distal forearm.…”

Section: Introductionmentioning

confidence: 99%

Explorative study of the sensitivity and specificity of the pronator quadratus fat pad sign as a predictor of subtle wrist fractures

et al. 2012

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ObjectiveTo investigate the value of post-traumatic pronator quadratus (PQ) fat pad sign as a reliable predictor of subtle wrist fractures.Materials and methodsThis was a prospective study of 68 patients undergoing X-ray for traumatic wrist injuries and subsequent MRI. The reliability of a positive PQ fat pad sign on X-ray, defined as either raised, interrupted or obliterated, was evaluated in detection of subtle wrist fractures.ResultsOut of 68 patients, 28 had a positive PQ sign without any obvious bony injuries on plain radiographs; of these, the PQ fat pad was obliterated in 11, disrupted in 12, and raised in five cases. Fractures defined as cortical interruption or trabecular fractures were revealed in 13/28 (46 %) patients with a positive PQ sign but only in 7/40 (18 %) patients with a negative sign. With regards to different types of abnormal PQ fat planes, fractures were present in 7/12 patients with a disrupted plane (58 %), 6/11 patients with an obliterated plane (54 %), and none of the patients with a raised plane. The overall sensitivity and specificity of a positive PQ sign in the prediction of occult wrist fractures were 65 and 69 %, respectively.ConclusionsOur findings indicate that a positive pronator quadratus (PQ) fat pad sign is not a reliable predictor of subtle fractures of the wrist, although we believe that it is a useful radiographic sign in justifying MRI for further clarification of possible joint abnormalities including occult fracture and cortex interruption.

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“…In addition to these functions, the PQ muscle is the key point indicator in the diagnosis of occult distal forearm fractures on plain radiographs [4,16]. However, sensitivity and specificity of the pronator sign has been questioned in the literature regarding the diagnosis of occult distal forearm fractures on plain radiographs [5,6,8,18].…”

Section: Discussionmentioning

confidence: 99%

Relationship of side dominance and ultrasonographic measurements of pronator quadratus muscle along with handgrip and pinch strength.

et al. 2016

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Aims: We ascertained effects of hand dominance in both right and left-handed volunteers on the thickness and cross sectional area (CSA) of pronator quadratus (PQ) muscle as measured by the axial and sagittal views of ultrasound imaging. Secondly, we also aimed to document the extent of the relationship between the PQ measurements and handgrip. Materials and methods: Healthy adults from the volunteer medical staff were included in the study. Handedness was assessed via The Flinders Handedness survey. The sonographic appearance of the PQ was evaluated on sagittal and axial images for both hands. CSA of PQ muscle was digitally drawn and calculated on the axial plane. Handgrip was measured by using adjustable-handle dynamometer. Results: Eighty-nine healthy volunteers were included (54 right and 35 left-handed). Significant difference was detected between dominant and non-dominant hands in CSA and muscle thickness in both right and left-handed volunteers (p<0.05). These measurements were correlated with the handgrip strength (p<0.05, r=0.55, and r=0.43 for right-handed volunteers, r=0.67 and r=0.48 for left-handed volunteers, respectively). There were also significantly high correlations between the measurements of CSA and PQ thickness of the corresponding extremity in both right-handed and left-handed volunteers (p<0.05). Conclusions: A statistically significant difference exists between dominant and non-dominant hands in CSA and muscle thickness measured by US in both right and left handed volunteers, and this is correlated with handgrip strength. Hand dominance should be considered to compare healthy and affected sites during US of PQ while investigating for occult fractures of distal forearm or PQ atrophy due to anterior interosseous nerve injury.

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The value of soft tissue signs in wrist trauma

Cited by 16 publications

References 5 publications

Sonographic Appearance of the Pronator Quadratus Muscle in Healthy Volunteers

Sonographic Appearance of the Pronator Quadratus Muscle in Healthy Volunteers

Explorative study of the sensitivity and specificity of the pronator quadratus fat pad sign as a predictor of subtle wrist fractures

Relationship of side dominance and ultrasonographic measurements of pronator quadratus muscle along with handgrip and pinch strength.

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