THE EVALUATION OF DIAGNOSTIC ACCORDANCE BETWEEN PLAIN RADIOGRAPHY AND BONE SCINTIGRAPHY FOR THE ASSESSMENT OF STERNUM AND RIB FRACTURES IN THE EARLY PERIOD OF BLUNT TRAUMA

Objective. To evaluate the diagnostic accordance between scintigraphy and radiography in the early period following blunt thoracic trauma. Design. Double-blind, prospective clinical study Methods. Thirty-four adult patients with blunt thoracic trauma were examined by plain radiography and scintigraphy within 24 hours of trauma. Results. Radiography displayed pathologies in 25 (73,5%), while scintigraphy suggested pathologies in 24 (70,5%) patients. Rib fractures were identified radiographically in 16 (47%) and scintigraphically in 17 (50%) patients. Lateral radiograph of the sternum showed fracture in 10 (52,6%), while scintigraphy suggested fracture in 14 (73,6%) patients with suspected sternal trauma. Conclusion. Scintigraphy gave better results in the evaluation of sternal fractures during the early period of thorax trauma. Conventional plain radiography is thought to be the initial imaging modality, because it saves time and shows hemothorax orpneumothorax besides the osseous abnormality

KÜNT TRAVMANIN ERKEN DÖNEMÝNDE STERNUM VE KABURGA KIRIKLARININ SAPTANMASINDA DÝREKT GRAFÝ VE SÝNTÝGRAFÝ ARASINDAKÝ TANISAL UYUMUN DEÐERLENDÝRÝLMESÝ

Amaç. Künt toraks travmasýnda erken dönemde sintigrafi ve direkt grafi arasýndaki tanýsal uyumun deðerlendirilmesi Tasarým. Çift kör, prospektif klinik çalýþma Yöntem. Acil Servise künt toraks travmasýyla baþvuran 34 eriþkin hasta travmayý takip eden ilk 24 saat içinde toraks sintigrafisi ve direkt akciðer grafisiyle incelendiler. Bulgular. Konvansiyonel radyografi 25 hastada (%73,5), Tc-99m kemik sintigrafisi ise 24 hastada (%70,5) patoloji belirledi. Radyografiyle 16 hastada (%47), sintigrafiyle 17 hastada (%50) kot fraktürü saptandý. Sternum fraktürü þüphesi olan 19 hastanýn 10'unda (%52,6) lateral sternum grafisinde ve 14'ünde (%73,6) sintigrafide sternum kýrýðý izlendi. Tartýþma. Çalýþmamýzda, travmanýn erken döneminde sternum kýrýklarýnýn saptanmasýnda sintigrafi direkt grafiye göre daha iyi sonuç vermiþtir. Ancak acil koþullarda konvansiyonel radyografi hem hýzý, hem de kemik patolojilerinin yaný sýra plevral boþluðun da deðerlendirilebilmesi açýsýndan daha pratiktir.