George Athanasatos MD, Presenter: Nothing to Disclose

Yousef Yasin MD, Abstract Co-Author: Nothing to Disclose

Bahram Kiani MD, Abstract Co-Author: Nothing to Disclose

Scott David Wuertzer MD, MS, Abstract Co-Author: Nothing to Disclose

Leon Lenchik MD, Abstract Co-Author: Nothing to Disclose

1. The goal of every on-call resident is to avoid missing fractures, but the importance of avoiding fracture overcalls should be equally emphasized. 2. Increased awareness of the types of overcalls and their common locations will help reduce their number. 3. Avoiding fracture overcalls may help reduce unnecessary cross-sectional imaging, relieve patient anxiety, and decrease unwarranted treatment.  

Introduction a. Missed fractures versus imaginary fractures b. Pediatric versus adult patients c. Suboptimal patient positioning d. Ossification centers e. Osteopenia Overcalls occur more frequently at common fracture locations a. Supracondylar distal humerus (children) b. Scaphoid (adults) c. Tibial plateau (adults) d. Distal radius (children and adults) Types of overcalls a. Sesamoid bones b. Osteophytes c. Nutrient foramina/vascular channels d. Remote fractures e. Enthesophytes f. Heterotopic bone g. Vascular calcifications h. Physeal scars i. Growth arrest/recovery lines j. Schmorl’s nodes Specific locations a. Hand and wrist b. Foot ankle Special considerations a. Stress fractures b. Insufficiency fractures Consequences a. Additional testing, usually unnecessary cross-sectional imaging b. Increased patient anxiety c. Unwarranted treatment  Conclusions  

http://abstract.rsna.org/uploads/2014/14015565/14015565_fmbr.pdf

Athanasatos, G, Yasin, Y, Kiani, B, Wuertzer, S, Lenchik, L, Avoiding Fracture Overcalls: Tips for On-Call Residents.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015565.html