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The usefulness of CT for patients with carpal bone fractures in the emergency department

 Je Sung You  ;  Sung Pil Chung  ;  Seung Ho Kim  ;  Hahn Shick Lee  ;  In Cheol Park  ;  Hyun Soo Chung 
 EMERGENCY MEDICINE JOURNAL, Vol.24(4) : 248-250, 2007 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Carpal Bones/diagnostic imaging* ; Carpal Bones/injuries* ; Emergency Service, Hospital ; Female ; Fractures, Bone/diagnostic imaging* ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed/methods*
Objective: The wrist is the most commonly injured joint in the body. However, wrist injuries are often missed in the emergency department (ED). If the fracture is not diagnosed and remains untreated, the patient runs a considerable risk of chronic disability. The utility of CT as an aid in the diagnosis of carpal bone fracture was investigated. Materials and methods: A retrospective analysis was performed of patients who underwent CT and plain radiography for wrist injury in the ED between March 2003 and February 2006. Plain radiograph interpretations were classified into three groups: (1) the definite fracture group, (2) the no fracture group, and (3) the ambiguous fracture group. The CT results were analysed in relation to the classification of the plain radiograph interpretation. The final diagnoses reviewed from the medical records were used as the reference standard. Results: 36 carpal fractures in 33 patients were identified from 45 patients who underwent plain radiography and CT. The interpretations of plain radiographs were classified into definite fractures (n = 10), ambiguous fractures (n = 15) and no fractures (n = 20). When both the definite fracture and ambiguous fracture groups were considered positive, the sensitivity and specificity were 69.7% and 83.3%, respectively. The sensitivity and specificity of CT scans were both 100%. Conclusion: Emergency physicians should consider CT of the wrist after plain radiography when patients with suspected carpal fracture show normal radiographic findings.
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1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Ho(김승호)
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
Lee, Hahn Shick(이한식)
Chung, Sung Pil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
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