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[考虑放射学报告中的问题:犬猫的Salter-Harris骨折——1997年至2012年间245例病例的回顾性分析]

[Salter-harris fractures in dogs and cats considering problems in radiological reports--a retrospective analysis of 245 cases between 1997 and 2012].

作者信息

Engel Eva, Kneiss Sibylle

机构信息

Abteilung für Bildgebende Diagnostik, Department für Kleintiere und Pferde, Veterinärmedizinische Universität Wien.

出版信息

Berl Munch Tierarztl Wochenschr. 2014 Jan-Feb;127(1-2):77-83.

Abstract

To identify typical trauma patterns or frequent radiological pitfalls that could help a radiologists in their daily routine, a retrospective study of Salter-Harris fractures in dogs and cats was performed. Radiographs obtained in the period 1991-2012 of 288 fractures in 245 patients with suspected injuries affecting growth plates in the appendicular skeleton were retrieved from the imaging archive. The femur was the bone most frequently affected (46.5%), followed by the humerus (19.8%), tibia (13.5%) and radius (11.8%). The distal growth plate was in all bones more often involved than the proximal growth plate (79.5% vs. 20.5%). The frequency of Salter-Harris fractures was 39.9% type I, 37.8% type II, 3.1% type III and 19.1% type IV. In dogs the most common physeal fracture was a type IV fracture of the of the distal femur. Radiographically, physeal fractures were recognized by at least two Roentgen signs, including change in opacity, displacement of the epiphysis or the Thurston-Holland sign. On the basis of the review, the original radiographic reports of 44/288 fractures were considered erroneous regarding the incorrect Salter Harris grouping. In 5/44 instances, the radiological examination had technical deficiencies that may have contributed to the errors, including 3 with oblique projections. Minimal variations in the projection was evident in the majority of reviewed cases. Measures to help optimize radiographic reports will be discussed.

摘要

为了确定有助于放射科医生日常工作的典型创伤模式或常见的放射学陷阱,对犬猫的Salter-Harris骨折进行了一项回顾性研究。从影像存档中检索了1991年至2012年期间245例怀疑影响四肢骨骼生长板损伤患者的288处骨折的X线片。股骨是最常受影响的骨骼(46.5%),其次是肱骨(19.8%)、胫骨(13.5%)和桡骨(11.8%)。所有骨骼的远端生长板比近端生长板更常受累(79.5%对20.5%)。Salter-Harris骨折的发生率为I型39.9%、II型37.8%、III型3.1%和IV型19.1%。在犬中,最常见的骨骺骨折是股骨远端的IV型骨折。在X线片上,骨骺骨折至少通过两种X线征象来识别,包括密度改变、骨骺移位或Thurston-Holland征。根据回顾,288处骨折中有44处的原始X线报告因Salter Harris分组错误而被认为有误。在44例中有5例,放射学检查存在技术缺陷,可能导致了这些错误,其中3例为斜位投照。在大多数回顾病例中,投照的最小差异很明显。将讨论有助于优化X线报告的措施。

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