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

Cho,  Sung Uk; Yang,  Jung Il; Han,  Kyu Hong; Cho,  Yong Chul; Yoo,  In Sool; Kim,  Seung Whan; Lee,  Jin Woong; Ryu,  Seung; You,  YeonHo; Han,  Sang Gyun; Park,  Seung Soo; Jung,  Won Jun; Lee,  Won Suk

J Korean Soc Emerg Med > Volume 21(5); 2010 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2010;21(5): 569-574.

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

Sung Uk Cho, Jung Il Yang, Kyu Hong Han, Yong Chul Cho, In Sool Yoo, Seung Whan Kim, Jin Woong Lee, Seung Ryu, YeonHo You, Sang Gyun Han, Seung Soo Park, Won Jun Jung, Won Suk Lee

¹Department of Emergency Medicine, Chungnam National University Hospital, Korea. yyo1003@naver.com
²Department of Emergency Medicine, Pusan National University Hospital, Korea.
³Department of Emergency Medicine, Konyang University Hospital, Korea.
⁴Department of Emergency Medicine, Dong-A University Hospital, Korea.

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.

Key words: Radius fractures, Emergencies, Intra-articular fractures