Should I take CT or X-ray for a fracture

After a fracture occurs, first aid measures should be taken immediately and go to the hospital for appropriate examinations in time. Only after the examination can you understand the specific situation of the fracture and then take the next step of treatment and conditioning. Generally speaking, there are many items that need to be examined after a fracture. First, you can do a film examination, that is, an X-ray. This is the most common method of examination for fractures. The examination methods for different fractures will also be different.

Fracture CT or X-ray

In clinical work, chest X-ray examination is sufficient. It is recommended to re-examine after two weeks. It is impossible for a fracture to heal in a short period of time, so it is of little significance. These two tests will not cause any discomfort to the body. In daily life, pay attention to rest, immobilize the affected area and reduce activities, strengthen nutrition, increase resistance, supplement vitamins and trace elements, and check treatment and rehabilitation exercises on time.

Patients with fractures can be examined using the following examination methods:

(1) X-ray is the preferred examination for diagnosing rib fractures, mainly because it is convenient to examine, more convenient to locate the fracture, and has low cost. The fracture site can be observed, and the fracture line or dislocation of the rib ends can also be seen. It can also help to understand whether there is any damage or complications to the internal organs in the chest. However, it should be noted that non-displaced fractures, fractures in the axillary area or fractures in the costal cartilage are not easy to show on X-rays and are easily missed in the early stages. Taking another chest X-ray 3 to 6 weeks after the injury may show a shadow formed by bone callus after the fracture. For sternal fractures, the fracture image can only be clearly shown on the lateral sternal radiograph.

(2) CR films have significantly improved the display of rib fractures compared to traditional X-ray films due to the addition of window technology. Most rib fractures can be detected. However, due to overlapping structures, fractures of the ribs below the diaphragm, the costal arch, and the anterior ribs are still difficult to display on CR films. Some fractures without obvious dislocation of the broken ends and fissure fractures are often missed, especially fissure fractures. CR films also have defects in the diagnosis of some old fractures with unclear bone callus, and the diagnosis cannot be clear.

(3) Spiral CT and reconstructed images are more sensitive and accurate than CR films in showing rib fractures. There is a statistical difference between the two, which is consistent with some literature reports. Spiral CT can perform rapid and continuous scanning and volumetric data acquisition, can perform post-processing image reconstruction at multiple angles and planes, can display lesions clearly and intuitively, and requires less cooperation from patients than CR radiography. It shows the complications of chest injuries more clearly and comprehensively than CR films.

(4) Combining CT cross-sectional and reconstructed images can more accurately observe the location of the fracture line. It has obvious advantages for subdiaphragmatic fractures, costal arch fractures, anterior rib fractures, and non-displaced fractures and fissure fractures that are easily missed on CR films. It is considered to be the most accurate method for diagnosing rib fractures. CR films of fissure fractures can only indicate suspected fractures and are easily overdiagnosed. Thin-layer scanning and reconstruction of spiral CT can solve diagnostic problems. For costal cartilage injuries, spiral CT can show the morphology and internal structural changes of the costal cartilage through post-reconstruction images, and can give a more accurate diagnosis. For patients whose CR films fail to show fractures but who are highly suspected of fractures clinically, especially those suspected of incomplete fractures below the diaphragm, spiral CT examination is recommended to avoid missed diagnosis. If there is a dispute and the patient needs a clear diagnosis, spiral CT examination should be considered regardless of whether the CR film finds a fracture.