Contents
Diagnosing Triquetrum Fractures: Why X-rays Aren't Always Enough
Published: Apr 29, 2024
Triquetrum fractures can be tricky to diagnose, often eluding detection on standard X-rays. Understanding the full range of diagnostic tools is crucial for accurate identification and proper treatment.
The Limitations of Standard X-rays
While X-rays are typically the first line of imaging for suspected wrist fractures, they have a surprisingly low sensitivity for triquetrum fractures. Studies show that standard radiographs may miss up to 70-80% of these fractures. This is partly due to the small size of the triquetrum and its position in the wrist, which can make fractures difficult to visualize on standard views.
Advanced Imaging: CT and MRI
When X-rays are inconclusive but clinical suspicion remains high, advanced imaging techniques come into play. Computed Tomography (CT) scans provide detailed 3D images of the bone, making them highly effective at identifying fractures. Magnetic Resonance Imaging (MRI) goes a step further, showing not only bone injuries but also damage to surrounding soft tissues like ligaments.
The Role of Cone Beam CT
Cone Beam CT (CBCT) is an emerging technology that's particularly useful for diagnosing carpal fractures. It provides high-resolution images with less radiation exposure than standard CT. CBCT has shown superior sensitivity in detecting radiocarpal fractures compared to plain radiographs, making it an excellent option when triquetrum fracture is suspected.
Clinical Examination: The First Step
Before any imaging, a thorough clinical examination is crucial. The physician will look for point tenderness over the triquetrum, typically 1-2 cm distal to the ulnar styloid. They may also perform specific maneuvers to stress the triquetrum and elicit pain. This clinical assessment guides the decision on which imaging studies to pursue.
Frequently Asked Questions
The bone's small size and position can make fractures difficult to see on standard views.
CT is excellent for bone detail, while MRI is superior for soft tissue injuries.
CBCT shows high accuracy and is becoming increasingly favored for carpal fracture diagnosis.
While not typically used, ultrasound can sometimes detect fractures and is useful for soft tissue injuries.
Immediate imaging is best, but fractures can often be detected even weeks after injury.
The Bottom Line
Accurate diagnosis of triquetrum fractures often requires a combination of clinical examination and advanced imaging techniques.
References
- Welling RD, et al. AJR Am J Roentgenol 2008; 190:10.
- Balci A, et al. Emerg Radiol 2015; 22:251.
This article has been reviewed for accuracy by one of the licensed medical doctors working for Doctronic. Always discuss health information with your healthcare provider.
AI Doctor Visit Required
Appointments available 24/7
Top licensed doctors
Available in all 50 states
Full service care
Prescriptions, referrals & treatment
No insurance needed
All notes available in Doctronic
15-min consultation. No hidden costs.
AI Doctor Visit Required
Please Chat With Our AI Doctor First
Our AI doctor assessment helps our human doctors prepare for your video visit and provide better care
For safety reasons we have been forced to end this consultation.
If you believe this is a medical emergency please call 911 or your local emergency services immediately.
If you are experiencing emotional distress, please call the the Suicide & Crisis Lifeline at 988 or your local crisis services immediately.
Contact us
You can also email us at help@doctronic.ai
We aim to reply within 5-7 days
How likely are you to recommend Doctronic to friends or family?