创伤性急诊X线摄影骨折漏诊17例分析

目的 分析临床急诊骨折X线漏诊原因,探讨创伤性急诊影像学检查方法与作用.方法 对17例急诊X线摄影骨折漏诊病例的临床及影像学资料进行回顾性分析.结果 漏诊骨折的部位分别是:肋骨骨折2例,脊椎骨折3例,腕舟骨及颅底骨折各1例,髋关节、骶髂关节骨折各2例,肘关节及膝关节骨折各3例.漏诊的原因有:X线投照体位及条件等技术因素6例,诊断医师没有注意骨折的间接征及细致检查患者5例,对隐匿部位骨折认识不足4例,其余2例重叠部位骨折.结论 改进对急诊患者X线照片的质量,提高对常见隐匿部位骨折及骨折间接征象的认识、细致检查患者症状体征可以提高骨折的检出率,减少漏诊发生.

X-ray misdiagnosis of traumatic occlusion emergency with bone fracture: 17 cases report

Objective To analysis the cause of X-ray missed diagnosis for emergency bone fracture. Methods Imaging findings of 17 patients with bone fracture examined with X-ray were enrolled. All cases were missed diagnosed. Results The lesion locations were: rib (2 cases), vertebrae (2 cases), scaphoid (1 case) and cranial base (1 case), articulatio coxae (2 case), articulatio coxae (2 cases), articulatio cubiti and articular genu (each 3 cases). The reasons for missed diagnosis included: X-ray body position of projection and technique factors (6 cases); ignorance for indirect manifestation of bone fracture or no prudent examination on patients (5 cases); inadequate knowledge on dormant position bone fracture (4 cases); overlapped bone fracture (2 cases). Conclusion Correct diagnosis rate can be enhanced along with improved X-ray imaging quality, more knowledge on dormant region bone fracture and indirect manifestation of bone fracture, prudent examination on patients.