Distal radius fracture differential diagnosis: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
m (Bot: Removing from Primary care)
 
(5 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Distal radius fracture}}
{{Distal radius fracture}}
{{CMG}}; {{AE}} {{Rohan}}
{{CMG}}; {{AE}} {{Rohan}}


==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==
* [[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>


==Differentiating [Disease name] from other Diseases==
* Distal radius fracture must be differentiated from other diseases that wrist pain, restriction of movements, and deformity, such as wrist pain, ligamentous carpal injury such as scapholunate ligament and triangular fibrocartilage complex (TFCC) tear.
{|
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
Line 31: 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; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Distal fragment displacement
* Distal fragment displacement
Line 45: 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; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" |
* No evidence of [[Bone fracture|fracture]] on radiographs
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* No evidence of fracture on radiographs
* No evidence of [[Bone fracture|fracture]] on CT
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* No evidence of fracture on CT
* [[Soft tissue]] swelling and tear may be seen
| style="background: #F5F5F5; padding: 5px;" |
* 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; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" |
* No evidence of [[Bone fracture|fracture]] on radiographs
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* No evidence of fracture on radiographs
* No evidence of [[Bone fracture|fracture]] on CT
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* No evidence of fracture on CT
* Swelling and tear of the [[ligament]] may be seen
| style="background: #F5F5F5; padding: 5px;" |
* 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;" |
* Most common injury is scapholunate ligament tear with widening of the scapholunate interval.
* Most common injury is [[scapholunate]] ligament tear with widening of the scapholunate interval.
* 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; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |+/-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +/-
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px; text-align: center;" | +
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px;" |-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | -
| style="background: #F5F5F5; padding: 5px; text-align: center;" |
* No evidence of [[Bone fracture|fracture]] on radiographs
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* No evidence of fracture on radiographs
* No evidence of [[Bone fracture|fracture]] on CT
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* No evidence of fracture on CT
* Swelling and tear of the [[ligament]] may be seen
| style="background: #F5F5F5; padding: 5px;" |
* 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;" |
* Wrist arthroscopy can be useful in visualizing and repairing TFCC tear
* Wrist [[arthroscopy]] can be useful in visualizing and repairing [[TFCC tear]]
|}
|}


Line 105: Line 106:
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Needs content]]
[[Category:Needs content]]
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Orthopedic surgery]]
[[Category:Orthopedic surgery]]
[[Category:Primary care]]
[[Category:Fractures]]
[[Category:Fractures]]
[[Category:Bone fractures]]
[[Category:Bone fractures]]

Latest revision as of 21:25, 29 July 2020

Distal radius fracture Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Distal radius fracture from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Non-Operative Treatment

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Distal radius fracture differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Distal radius fracture differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Distal radius fracture differential diagnosis

CDC on Distal radius fracture differential diagnosis

Distal radius fracture differential diagnosis in the news

Blogs on Distal radius fracture differential diagnosis

Directions to Hospitals Treating Distal radius fracture

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

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 + + + + + +/-
  • Distal fragment displacement
  • Distal fragment angulation
  • Radial shortening
  • Useful for preoperative surgical planning for patients with complex, multifragmentary fractures.
 X-ray
Wrist strain + + - + - - MRI
Ligamentous carpal injury + + +/- + - -
  • Swelling and tear of the ligament may be seen
 MRI
  • Most common injury is scapholunate ligament tear with widening of the scapholunate interval.
  • Positive Watson shift test.
Triangular fibrocartilage complex (TFCC) tear + +/- - + - -
  • Swelling and tear of the ligament may be seen
 MRI

References

  1. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Distal_radius_fracture_differential_diagnosis&oldid=1637313"