Distal radius fracture differential diagnosis: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
No edit summary |
||
Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
Distal radius fracture must be differentiated from wrist strain, ligamentous carpal injury such as scapholunate ligament and triangular fibrocartilage complex (TFCC) tear. | [[Distal radius fracture]] must be differentiated from [[wrist strain]], [[Ligamentous laxity|ligamentous]] carpal injury such as [[scapholunate]] ligament and [[triangular fibrocartilage]] complex (TFCC) tear. | ||
==Differentiating Distal Radius Fracture from other Diseases== | ==Differentiating Distal Radius Fracture from other Diseases== | ||
* Distal radius fracture must be differentiated from other diseases that wrist pain, restriction of movements, and deformity, such as wrist | * [[Distal radius fracture]] must be differentiated from other diseases that [[wrist pain]], [[restriction of movements]], and [[deformity]], such as [[wrist strain]], [[Ligamentous laxity|ligamentous]] carpal injury such as [[scapholunate ligament]] and [[triangular fibrocartilage]] complex (TFCC) tear.<ref name="pmid8423324">{{cite journal| author=Trumble TE, Benirschke SK, Vedder NB| title=Ipsilateral fractures of the scaphoid and radius. | journal=J Hand Surg Am | year= 1993 | volume= 18 | issue= 1 | pages= 8-14 | pmid=8423324 | doi=10.1016/0363-5023(93)90237-W | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8423324 }} </ref><ref name="pmid9726557">{{cite journal| author=Stoffelen D, De Mulder K, Broos P| title=The clinical importance of carpal instabilities following distal radial fractures. | journal=J Hand Surg Br | year= 1998 | volume= 23 | issue= 4 | pages= 512-6 | pmid=9726557 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9726557 }} </ref><ref name="pmid12457345">{{cite journal| author=May MM, Lawton JN, Blazar PE| title=Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability. | journal=J Hand Surg Am | year= 2002 | volume= 27 | issue= 6 | pages= 965-71 | pmid=12457345 | doi=10.1053/jhsu.2002.36525 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12457345 }} </ref><ref name="pmid16039453">{{cite journal| author=Lindau T| title=Treatment of injuries to the ulnar side of the wrist occurring with distal radial fractures. | journal=Hand Clin | year= 2005 | volume= 21 | issue= 3 | pages= 417-25 | pmid=16039453 | doi=10.1016/j.hcl.2005.04.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16039453 }} </ref> | ||
{| | {| | ||
Line 32: | Line 32: | ||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MRI | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |MRI | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Distal radius fracture | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Distal radius fracture]] | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+/- | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Distal fragment displacement | * Distal fragment displacement | ||
Line 46: | Line 46: | ||
* Useful for preoperative surgical planning for patients with complex, multifragmentary fractures. | * Useful for preoperative surgical planning for patients with complex, multifragmentary fractures. | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Useful in diagnosing occult fractures, ligamentous and soft tissue injuries | * Useful in diagnosing occult [[Bone fracture|fractures]], [[Ligamentous laxity|ligamentous]] and [[soft tissue]] injuries | ||
| style="background: #F5F5F5; padding: 5px;" |X-ray | | style="background: #F5F5F5; padding: 5px;" |X-ray | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Wrist strain | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Wrist strain | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |- | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |- | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |- | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* No evidence of fracture on radiographs | * No evidence of [[Bone fracture|fracture]] on radiographs | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* No evidence of fracture on CT | * No evidence of [[Bone fracture|fracture]] on CT | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Soft tissue swelling and tear may be seen | * [[Soft tissue]] swelling and tear may be seen | ||
| style="background: #F5F5F5; padding: 5px;" |MRI | | style="background: #F5F5F5; padding: 5px;" |MRI | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Ligamentous carpal injury | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Ligamentous carpal injury | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+/- | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |- | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |- | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* No evidence of fracture on radiographs | * No evidence of [[Bone fracture|fracture]] on radiographs | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* No evidence of fracture on CT | * No evidence of [[Bone fracture|fracture]] on CT | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Swelling and tear of the ligament may be seen | * Swelling and tear of the [[ligament]] may be seen | ||
| style="background: #F5F5F5; padding: 5px;" |MRI | | style="background: #F5F5F5; padding: 5px;" |MRI | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
Line 84: | Line 84: | ||
* Positive Watson shift test. | * Positive Watson shift test. | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Triangular fibrocartilage complex (TFCC) tear | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Triangular fibrocartilage]] complex (TFCC) tear | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |+/- | | style="background: #F5F5F5; padding: 5px;" | +/- | ||
| style="background: #F5F5F5; padding: 5px;" |- | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |+ | | style="background: #F5F5F5; padding: 5px;" | + | ||
| style="background: #F5F5F5; padding: 5px;" |- | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" |- | | style="background: #F5F5F5; padding: 5px;" | - | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* No evidence of fracture on radiographs | * No evidence of [[Bone fracture|fracture]] on radiographs | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* No evidence of fracture on CT | * No evidence of [[Bone fracture|fracture]] on CT | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Swelling and tear of the ligament may be seen | * Swelling and tear of the [[ligament]] may be seen | ||
| style="background: #F5F5F5; padding: 5px;" |MRI | | style="background: #F5F5F5; padding: 5px;" |MRI | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | |
Revision as of 03:13, 14 December 2018
Distal radius fracture Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Distal radius fracture differential diagnosis On the Web |
American Roentgen Ray Society Images of Distal radius fracture differential diagnosis |
Risk calculators and risk factors for Distal radius fracture differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
Distal radius fracture must be differentiated from wrist strain, ligamentous carpal injury such as scapholunate ligament and triangular fibrocartilage complex (TFCC) tear.
Differentiating Distal Radius Fracture from other Diseases
- Distal radius fracture must be differentiated from other diseases that wrist pain, restriction of movements, and deformity, such as wrist strain, ligamentous carpal injury such as scapholunate ligament and triangular fibrocartilage complex (TFCC) tear.[1][2][3][4]
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical examination | ||||||||||
Imaging | |||||||||||
Pain | Restriction of Movements | Deformity | Tenderness | Decreased Grip Strength | Decreased sensation in course of Median nerve | X-ray | CT scan | MRI | |||
Distal radius fracture | + | + | + | + | + | +/- |
|
|
|
X-ray | |
Wrist strain | + | + | - | + | - | - |
|
|
|
MRI | |
Ligamentous carpal injury | + | + | +/- | + | - | - |
|
|
|
MRI |
|
Triangular fibrocartilage complex (TFCC) tear | + | +/- | - | + | - | - |
|
|
|
MRI |
|
References
- ↑ Trumble TE, Benirschke SK, Vedder NB (1993). "Ipsilateral fractures of the scaphoid and radius". J Hand Surg Am. 18 (1): 8–14. doi:10.1016/0363-5023(93)90237-W. PMID 8423324.
- ↑ Stoffelen D, De Mulder K, Broos P (1998). "The clinical importance of carpal instabilities following distal radial fractures". J Hand Surg Br. 23 (4): 512–6. PMID 9726557.
- ↑ May MM, Lawton JN, Blazar PE (2002). "Ulnar styloid fractures associated with distal radius fractures: incidence and implications for distal radioulnar joint instability". J Hand Surg Am. 27 (6): 965–71. doi:10.1053/jhsu.2002.36525. PMID 12457345.
- ↑ Lindau T (2005). "Treatment of injuries to the ulnar side of the wrist occurring with distal radial fractures". Hand Clin. 21 (3): 417–25. doi:10.1016/j.hcl.2005.04.002. PMID 16039453.