Objective: Physeal injuries in childhood may produce irreversible damage to the growing cells, resulting in growth disturbance. The aim of this study is compare conventional radiography and magnetic resonance imaging (MRI) in the assessment of distal radius epiphyseal and physeal injury.
Methods: 31 cases with distal radius trauma were examined with conventional radiography and MRI. One blinded experienced radiologists and one blinded experienced specialist in orthopedics separately evaluated the results.
Results: The main age of our patient was 11.74±2.98 years. The results of MRI showed 90.32% injury in all patients whiles conventional radiography showed 64.51% injuries (P=0.014). In survey the physeal injury by conventional radiography we have 6 Salter–Harris II fractures. Meanwhile, the MRI showed 9 physeal injuries that included 6 Salter–Harris II fracture and 3 other fracture with physeal injury (all of them had distal radius microfracture with mild physeal injury) (P>0.05). In patients that conventional radiography showed they were normally, MRI showed 4 Bone Bruising and 4 microfracture. The other results were similar. The sensitivity, specificity, Positive predictive value, negative predictive value and total accuracy of conventional radiography in diagnosis of physeal injury were 66.6%, 100%, 100%, 88%, 90.32%.
Conclusion: our study showed MRI and conventional radiography had almost similar power to diagnosis growth plate injuries in distal radius trauma. When we considering high cost of MRI, it’s seems that conventional radiography was beneficial than MRI to use in distal radius injury. |
|
1. 1. Rauch F. Bone growth in length and width: the Yin and Yang of bone stability. Journal of Musculoskeletal and Neuronal Interactions. 2005;5(3):194.
2. Laor T, Jaramillo D. MR Imaging Insights into Skeletal Maturation: What Is Normal? 1. Radiology. 2009;250(1):28-38.
3. Yanaguizawa M, Taberner GS, Aihara AY, Yamaguchi CK, Guimarães MC, Rosenfeld A, et al. Imaging of growth plate injuries. Radiologia Brasileira. 2008;41(3):199-204.
4. Schurz M, Binder H, Platzer P, Schulz M, Hajdu S, Vécsei V. Physeal injuries of the distal tibia: long-term results in 376 patients. International orthopaedics. 2010;34(4):547-52.
5. Ecklund K, Jaramillo D. IMAGING OF GROWTH DISTRUBANCE IN CHILDREN. Radiologic clinics of North America. 2001;39(4):823-41.
6. Renner JB. Conventional radiography in musculoskeletal imaging. Radiologic Clinics of North America. 2009;47(3):357-72.
7. White PG, Mah JY, Friedman L. Magnetic resonance imaging in acute physeal injuries. Skeletal radiology. 1994;23(8):627-31.
8. Mack MG, Keim S, Balzer JO, Schwarz W, Hochmuth K, Windolf J, et al. Clinical impact of MRI in acute wrist fractures. European radiology. 2003;13(3):612-7.
9. Carey J, Spence L, Blickman H, Eustace S. MRI of pediatric growth plate injury: correlation with plain film radiographs and clinical outcome. Skeletal radiology. 1998;27(5):250-5.
10. Welling RD, Jacobson JA, Jamadar DA, Chong S, Caoili EM, Jebson PJ. MDCT and radiography of wrist fractures: radiographic sensitivity and fracture patterns. American Journal of Roentgenology. 2008;190(1):10-6.
11. Shi D-P, Zhu S-C, Li Y, Zheng J. Epiphyseal and physeal injury: comparison of conventional radiography and magnetic resonance imaging. Clinical imaging. 2009;33(5):379-83.
12. Steinborn M, Schürmann M, Staebler A, Wizgall I, Pellengahr C, Heuck A, et al. MR imaging of ulnocarpal impaction after fracture of the distal radius. American Journal of Roentgenology. 2003;181(1):195-8.
13. Carter S, Aldridge M, Fitzgerald R, Davies A. Stress changes of the wrist in adolescent gymnasts. The British journal of radiology. 1988;61(722):109-12.
14. Jaramillo D, Laor T, Zaleske DJ. Indirect trauma to the growth plate: results of MR imaging after epiphyseal and metaphyseal injury in rabbits. Radiology. 1993;187(1):171-8.
15. Griffith JF, Roebuck DJ, Cheng JC, Chan YL, Rainer TH, Ng BK, et al. Acute elbow trauma in children: spectrum of injury revealed by MR imaging not apparent on radiographs. American Journal of Roentgenology. 2001;176(1):53-60.
16. Zimmermann R, Rudisch A, Fritz D, Gschwentner M, Arora R. [MR imaging for the evaluation of accompanying injuries in cases of distal forearm fractures in children and adolescents]. Handchirurgie, Mikrochirurgie, plastische Chirurgie: Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie: Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse: Organ der V. 2007;39(1):60-7.
17. Jørgsholm P, Thomsen NO, Besjakov J, Abrahamsson S-O, Björkman A. The benefit of magnetic resonance imaging for patients with posttraumatic radial wrist tenderness. The Journal of hand surgery. 2013;38(1):29-33.
|
