隐匿骨折的影像诊断

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1、隐匿骨折的影像诊断龙昌平626000四川，廿孜州人民医院放射科【摘要】目的探讨准确诊断隐匿骨折，减少其谋漏诊的方法。从而避免因谋漏诊隐匿骨折而引起的医患纠纷。方法对我院2007〜2008年42例隐匿骨折患者进行回顾分析，用常规DR对思者进行的正侧位摄影结合正、斜、切线位双能址减影和CT、MRI检杏。结果首次常规DR正侧位摄影，捉示诊断的5例，怀疑诊断的9例，其屮次日或笫3FUIJ双能量减影复查明确诊断6例;做CT明确诊断16例;做MRI明确诊断5例;因临床症状不消，1周后来复查DR明确诊断的7例

2、，此7例均调阅当吋的DR或CT片，发现7例中除有1例是当时谋漏诊外，其余6例当时照片确实无骨折征象显示，将其称为愆不显示性隐匿骨折。这6例暂不显示性隐匿骨折屮有4例会诊报告示1周示复杏，有2例无此复杳提示，引起了医患纠纷。结论结合临床诊断隐匿骨折非常重耍，采取多体位摄像，多种检查手段诊断，对仍然难免的误漏诊暂不显示性隐匿骨折，会诊报告上一定要提示复查。【关键词】隐匿骨折;多种方法检查;误漏诊;医患纠纷;复查ImagingdiagnosisonoccultfractureLONGChang-pin

3、g.DepartmentofRadiology,GanziPeoplesHospital,Ganzi626000,China[Abstract]ObjectiveTryingtofindanaccuratediagnosisofoccultfracture^toreducetheerroroftheirwaysofmisseddiagnosis.Inordertoavoidmisseddiagnosisofoccultfractureinpatientdisputesarisingfromthe

4、occurrence.MethodsOn2007〜2008,42casesofoccultfracturepatientswereretrospectivelyanalyzed,DRofconventionalpatientsiscombinedwithphotographyinlateral,oblique,tangent-bitdual-energysubtractionandCT,MRIexamination.ResultsDRisthefirsttime,conventionallate

5、ralphotography,promptdiagnosiswere15cases;27casesweresuspecteddiagnosis;Onnextdayor3rddayuseddual-energysubtractiontoreviewcleardiagnosisof6cases;CTforacleardiagnosisof24cases;DirectlytootherhospitalforMRIdiagnosiswere5cascs(bccauseofwithoutequipment

6、);Asaresultofclinicalcoursc;aweeklaterreviewedDRcleardiagnosisof7cases,7caseswereavailableatthetimeoftheDRorCTfilmstoreview.Inthe7casesfound1casetherewasmissed,theother6easesatthetimeofphotosdidnotshowsignsoffracture,thencalledithiddenfractures.6case

7、sofhiddenfractures,4caseshadrechenckrequest,2caseswerenot,thencausedadisputebetweendoctorsandpatients.ConclusionClinicaldiagnosisofoccultfractureisveryimportant,multi-cameraposition,avarietyofmeanstocheckthediagnosis,theinevitablemistakenottoshowmiss

8、eddiagnosisofoccultfracture,consultationonthereportmustberequestedinoneweekafterthereview,ifstiuhasanysymptomsorcourse,pleaseaddtoreviewthefollow-upreport.[Keywords]occultfracture;avarietyofinspectionmethods;missedanddelayeddiagnosis;paticntdisputcs;