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Long Bone Trauma: Radiographic Pitfalls

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Pitfalls in Musculoskeletal Radiology

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Abstract

Radiography remains the imaging modality of choice for initial evaluation of the appendicular skeleton in the trauma setting, with other sophisticated modalities such as computed tomography or magnetic resonance imaging often assuming a secondary role. Studies have shown that most fractures missed on radiography are actually hiding in plain sight, becoming apparent on a second review of the radiographs in about two-thirds of cases. Factors which may constitute pitfalls to diagnosis include certain fractures and dislocations which are subtle by nature or which are obscured in areas of complex anatomy, lack of available clinical information, radiologist’s fatigue, satisfaction of search effect, and a defective knowledge base, among others. Heightened vigilance is needed when evaluating trauma radiographs so as to correctly identify potentially subtle traumatic lesions. Strategies to help improve radiologist’s perceptual and interpretative accuracy include adhering to a consistent search pattern, looking for the subtle and atypical signs of fractures such as avulsion fractures and stress fractures, and close scrutiny of anatomical locations at which fractures and other traumatic lesions are commonly missed.

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Abbreviations

CT:

Computed tomography

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Authors and Affiliations

  1. Department of Imaging Sciences, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA

    Robert B. Uzor MD, MRCS & Johnny U. V. Monu MBBS, MSc

  2. Radisphere National Radiology Group, Candescent Health, 221 Crescent Street, Suite 301, Waltham, MA, 02453, USA

    Thomas L. Pope MD, FACR

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  1. Robert B. Uzor MD, MRCS
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  2. Johnny U. V. Monu MBBS, MSc
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  3. Thomas L. Pope MD, FACR
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Correspondence to Robert B. Uzor MD, MRCS .

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  1. Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore

    Wilfred C. G. Peh

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Uzor, R.B., Monu, J.U.V., Pope, T.L. (2017). Long Bone Trauma: Radiographic Pitfalls. In: Peh, W. (eds) Pitfalls in Musculoskeletal Radiology. Springer, Cham. https://doi.org/10.1007/978-3-319-53496-1_12

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