创伤性急诊X线摄影骨折漏诊17例分析

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

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。

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.