Ulnar bone fracture diagnostic study of choice: Difference between revisions

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{{CMG}}; {{AE}}[[User:DrMars|Mohammadmain Rezazadehsaatlou[2]]] ;
{{CMG}}; {{AE}}[[User:DrMars|Mohammadmain Rezazadehsaatlou[2]]] ;
== Overview ==
== Overview ==
Radiographic parameters should be used to check the normal anatomy and to detect anatomical anomalies and fractures. X-rays to determine the location and extent of the break. Occasionally, another scan, such as an MRI, might be used to get more-detailed images.
Not all suspected fractures require imaging. Some fractures are minor and are treated similarly to soft-tissue injuries. Radiographic parameters should be used to check the normal anatomy and to detect anatomical anomalies and fractures. X-rays to determine the location and extent of the break. Occasionally, another scan, such as an MRI, might be used to get more-detailed images.


== Diagnostic Study of Choice ==
== Diagnostic Study of Choice ==
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<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
If imaging is needed, plain x-rays are done first.
'''Plain x-rays''' show primarily bone (and joint effusion secondary to bleeding or occult fracture) and thus are useful for diagnosing fractures. They should include at least 2 views taken in different planes (usually anteroposterior and lateral views).
Additional views (eg, oblique) may be done when
*  The evaluation suggests fracture and 2 projections are negative.
*  They are routine for certain joints (eg, a mortise view for evaluating an ankle, an oblique view for evaluating a foot).
*  Certain abnormalities are suspected.
For lateral views of digits, the digit of interest should be separated from the others.
'''MRI''' or '''CT''' can be used if
*  A fracture is not visible on plain x-rays but is strongly suspected clinically (common with scaphoid fractures and impacted femoral neck [subcapital] hip fractures).
*  More detail is needed to guide treatment (eg, for scapular fractures, pelvic fractures, or intraarticular fractures).
For example, if findings after a fall suggest hip fracture but x-rays are normal, MRI should be done to check for an occult hip fracture.
Other tests may be done to check for related injuries:
*  Arteriography or CT angiography to check for suspected arterial injuries
*  Electromyography and/or nerve conduction studies (rarely done immediately; more typically done when nerve symptoms persist weeks to months after the injury)


===== Diagnostic results =====
===== Diagnostic results =====

Revision as of 15:35, 28 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2] ;

Overview

Not all suspected fractures require imaging. Some fractures are minor and are treated similarly to soft-tissue injuries. Radiographic parameters should be used to check the normal anatomy and to detect anatomical anomalies and fractures. X-rays to determine the location and extent of the break. Occasionally, another scan, such as an MRI, might be used to get more-detailed images.

Diagnostic Study of Choice

Study of choice

X-ray is the gold standard test for the diagnosis of Ulnar bone fracture. But, occasionally, another imaging modalities such as CT scan and/or MRI, might be used to get more detailed images and information regarding the involved bone and near organs.

At least two radiographic projections ( anteroposterior [AP] and lateral) of the forearm should be obtained. These two view show the fracture, the extent of displacement, and the extent of injury. It should be noted that finding any foreign bodies in open fractures and gunshot injuries is an important fact in these type of injuries. Meanwhile, a tuberosity view may help ascertain the rotational displacement of the fracture. This would help in planning how much supination or pronation is needed to achieve accurate anatomic reduction.

The comparison of various diagnostic studies for [disease name]

Test Sensitivity Specificity
Test 1 ...% ...%
Test 2 ...% ...%

[Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity

If imaging is needed, plain x-rays are done first.

Plain x-rays show primarily bone (and joint effusion secondary to bleeding or occult fracture) and thus are useful for diagnosing fractures. They should include at least 2 views taken in different planes (usually anteroposterior and lateral views).

Additional views (eg, oblique) may be done when

  • The evaluation suggests fracture and 2 projections are negative.
  • They are routine for certain joints (eg, a mortise view for evaluating an ankle, an oblique view for evaluating a foot).
  • Certain abnormalities are suspected.

For lateral views of digits, the digit of interest should be separated from the others.

MRI or CT can be used if

  • A fracture is not visible on plain x-rays but is strongly suspected clinically (common with scaphoid fractures and impacted femoral neck [subcapital] hip fractures).
  • More detail is needed to guide treatment (eg, for scapular fractures, pelvic fractures, or intraarticular fractures).

For example, if findings after a fall suggest hip fracture but x-rays are normal, MRI should be done to check for an occult hip fracture.

Other tests may be done to check for related injuries:

  • Arteriography or CT angiography to check for suspected arterial injuries
  • Electromyography and/or nerve conduction studies (rarely done immediately; more typically done when nerve symptoms persist weeks to months after the injury)
Diagnostic results

The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:

  • [Finding 1]
  • [Finding 2]
Sequence of Diagnostic Studies

The [name of investigation] must be performed when:

  • The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
  • A positive [test] is detected in the patient, to confirm the diagnosis.

OR

The various investigations must be performed in the following order:

  • [Initial investigation]
  • [2nd investigation]

Name of Diagnostic Criteria

It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.

[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].

OR

There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].

OR

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

[Disease name] may be diagnosed at any time if one or more of the following criteria are met:

  • Criteria 1
  • Criteria 2
  • Criteria 3

OR

IF there are clear, established diagnostic criteria

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].

OR

The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].

OR

The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].

OR

IF there are no established diagnostic criteria

There are no established criteria for the diagnosis of [disease name].

References

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