J Korean Soc Emerg Med.  2010 Oct;21(5):569-574.

The Accuracy of a Simple Radiologic Study for Diagnosing Intra-articular Fractures of the Distal Radius

• Cho SU
• Yang JI
• Han KH
• Cho YC
• Yoo IS
• Kim SW
• Lee JW
• Ryu S
• You Y
• Han SG
• Park SS
• Jung WJ
• Lee WS

Abstract

PURPOSE
To determine the accuracy of a simple radiologic images as a diagnostic tool for intra-articular fractures of the distal radius (IAF).
METHODS
This study proceeded prospectively from April 2008 to December 2009. We let 25 ERs (emergency residents) interpret the radiologic images of 45 patients who had injuries of their wrists and presented to a hospital. We used surgical findings or multidetector computed tomography (MDCT) to confirm the final diagnosis of enrolled patients. Finally, we evaluated the sensitivity, specificity, and accuracy of simple radiologic images of IAF. We also compared test performance characteristics between the four grades of the ERs (1st, 2nd, 3rd, and 4th years) via Mann-Whitney and Kruskal-Wallis tests. We considered differences to be significant, if p<0.05
RESULTS
Of 45 patients, 40 (88.9%) had fractures of the distal radius; of the 40, 25 (62.5%) had IAF. There were no differences in sensitivity, specificity, or accuracy between the four grades of the ERs (p=0.86, 0.76, 0.49). The sensitivity of simple radiologic images for diagnosing IAF was 0.69; specificity was 0.77; accuracy was 0.72.
CONCLUSION
In this study, we found that simple radiologic images as the primary diagnostic tool for intra-articular fractures of the distal radius were not completely adequate. Therefore, ERs should carefully consider using MDCT imaging to diagnose patients who suffer from wrist pain.

Keyword

Radius fractures; Emergencies; Intra-articular fractures

MeSH Terms

Emergencies
Humans
Intra-Articular Fractures
Linear Energy Transfer
Multidetector Computed Tomography
Prospective Studies
Radius
Radius Fractures
Sensitivity and Specificity
Wrist