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

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Evidence-Based Emergency Imaging

Part of the book series: Evidence-Based Imaging ((Evidence-Based Imag.))

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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.

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Author information

Authors and Affiliations

  1. Department of Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Kara Gaetke-Udager & Corrie M. Yablon

  2. Department of Diagnostic, Interventional, and Pediatric Radiology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland

    Stefan Puig

  3. Department of Radiology and Neuroradiology, Klinik im Park, Hirslanden AG, Zurich, Switzerland

    Stefan Puig

Authors
  1. Kara Gaetke-Udager
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  2. Corrie M. Yablon
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  3. Stefan Puig
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Corresponding author

Correspondence to Kara Gaetke-Udager .

Editor information

Editors and Affiliations

  1. Department of Radiology, Division of Cardio-Thoracic Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Aine Kelly

  2. Department of Radiology, Division of Cardio-Thoracic Radiology, Michigan Medicine, Ann Arbor, MI, USA

    Paul Cronin

  3. Department of Diagnostic, Interventional, and Pediatric Radiology Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland

    Stefan Puig

  4. Department of Radiology, University of Kentucky Children’s Hospital, Lexington, KY, USA

    Kimberly E. Applegate

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Gaetke-Udager, K., Yablon, C.M., Puig, S. (2018). Upper Extremity Injuries in Adults and Children: Evidence-Based Emergency Imaging. In: Kelly, A., Cronin, P., Puig, S., Applegate, K. (eds) Evidence-Based Emergency Imaging. Evidence-Based Imaging. Springer, Cham. https://doi.org/10.1007/978-3-319-67066-9_29

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  • DOI: https://doi.org/10.1007/978-3-319-67066-9_29

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