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Upper Extremity Injuries in Adults and Children: Evidence-Based Emergency Imaging

  • Kara Gaetke-UdagerEmail author
  • Corrie M. Yablon
  • Stefan Puig
Chapter
Part of the Evidence-Based Imaging book series (Evidence-Based Imag.)

Abstract

Upper extremity trauma is a common reason for emergency department visits, and a number of upper extremity injuries pose diagnostic dilemmas in the acute setting and for short-term follow-up. Scaphoid fractures are often missed on initial radiographs, which results in unnecessary immobilization before subsequent reimaging. Magnetic resonance imaging (MRI) has the best sensitivity and specificity to evaluate for scaphoid fracture and should be considered in the acute setting. Elbow dislocation can be evaluated with radiographs, but any clinical concern for vascular injury should prompt evaluation with computed tomography angiography (CTA) or angiography. MRI is not necessary in the acute setting after elbow dislocation, but provides excellent soft tissue evaluation to aid in treatment decisions. Radiographs are a necessary first-line study to evaluate glenohumeral dislocation, and sometimes special views can be helpful. While MRI provides excellent soft tissue detail, MR arthrography might be necessary in the subacute setting to evaluate certain sequela of dislocation such as labral, ligamentous, and cartilage injury. Bilateral radiographs with non-weighted and weighted comparisons are needed to evaluate acromioclavicular joint separation. MRI can be useful in distinguishing low- from high-grade acromioclavicular separation, which is important for treatment planning.

Keywords

Scaphoid fracture Elbow dislocation Glenohumeral dislocation Acromioclavicular separation Radiography MRI CT Evidence-based imaging Emergency imaging 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Kara Gaetke-Udager
    • 1
    Email author
  • Corrie M. Yablon
    • 1
  • Stefan Puig
    • 2
    • 3
  1. 1.Department of RadiologyMichigan MedicineAnn ArborUSA
  2. 2.Department of Diagnostic, Interventional, and Pediatric Radiology, InselspitalUniversity Hospital Bern, University of BernBernSwitzerland
  3. 3.Department of Radiology and NeuroradiologyKlinik im Park, Hirslanden AGZurichSwitzerland

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