| Analysis of the management of occult fractures of the scaphoid through early magnetic resonance imaging. | |
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MedLine Citation:
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PMID: 22033035 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: We aimed to evaluate the usefulness of magnetic resonance imaging (MRI) in the diagnosis of occult fractures of the scaphoid and to determine the advantages and cost in comparison with the traditional follow-up protocol. MATERIAL AND METHOD: The traditional approach at our center consisted of immobilization and periodic clinical and radiological follow-up (plain-film X-rays and computed tomography in the final phase of the process). The new protocol called for a limited MRI study consisting of coronal T1- and T2-weighted fat suppression sequences if the findings at plain-film X-rays continued to be negative at the first follow-up examination with the traumatologist (10 days after trauma). We evaluated the MRI findings, the time the patient was immobilized, the cost of each protocol, and the dose of radiation received. RESULTS: We included 33 cases of patients with clinically suspected fractures of the scaphoid and negative findings on plain-film X-rays. In 13 patients, the MRI findings were negative. In 12 patients, the MRI findings confirmed the diagnosis of a fracture of the scaphoid, which was associated with other pathology in 6 cases. In 8 patients, another pathological process was diagnosed. The cost of the new protocol was €131.06 per patient; the cost of the traditional protocol was €114.41 or €151.06 per patient, depending on the follow-up studies required. The new protocol reduced the dose of radiation by eliminating successive radiologic studies. CONCLUSIONS: The new protocol improved the management of these patients, reducing the time of immobilization, improving joint rigidity, and reducing the time off work. The limited MRI study makes it possible to diagnose other radiologically occult lesions. The cost of the new protocol is similar to that of the traditional protocol and even lower in some cases. The new protocol results in a reduction in the dose of radiation. |
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Authors:
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M D Moreno Ramos; M Martínez Hervás; P Sanz Rupp; J Ramos Medrano |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-25 |
Journal Detail:
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Title: Radiologia Volume: - ISSN: 0033-8338 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0120775 Medline TA: Radiologia Country: - |
Other Details:
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Languages: ENG; SPA Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved. |
Affiliation:
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Servicio de Radiodiagnóstico, Hospital San Juan de Dios del Aljarafe, Bormujos, Sevilla, España. |
Vernacular Title:
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Análisis del manejo de fracturas ocultas de escafoides mediante la realización precoz de resonancia magnética. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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