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Cost description of clinical examination and MRI in wrist ligament injuries

Artikel i vetenskaplig tidskrift
Författare Jonny K Andersson
Elisabeth Hansson-Olofsson
Jon Karlsson
Jan Fridén
Publicerad i Journal of Plastic Surgery and Hand Surgery
Volym 52
Nummer/häfte 1
Sidor 30-36
ISSN 2000-656X
Publiceringsår 2018
Publicerad vid Institutionen för vårdvetenskap och hälsa
Institutionen för kliniska vetenskaper, Avdelningen för ortopedi
Institutionen för kliniska vetenskaper
Sidor 30-36
Språk en
Länkar doi.org/10.1080/2000656x.2017.13198...
Ämnesord Wrist, arthroscopy, magnetic resonance imaging, cost, triangular fibrocartilage complex, scapholunate ligament, lunotriquetral ligament, triangular fibrocartilage complex, arthroscopic diagnosis, tfcc tears, fractures, lesions, instability, radius, Orthopedics, Surgery, NTES D, 1992, Annales de Chirurgie de la Main et du Membre Superieur, V11, P119
Ämneskategorier Ortopedi

Sammanfattning

Objective: The total number and cost of wrist MRIs in the catchment area of the Vastra Gotaland Region in Sweden (population 1 723 000) during 1 year was analysed, together with the number and content of referrals. Methods: Six radiology departments reported the numbers and rate of all MRI investigations intended to diagnose wrist ligament injuries (n=411) and other injuries to the wrist. Results: The additional cost of the difference between MRIs and a clinical examination by a hand surgeon, plus indirect costs for patients with suspected wrist ligament injuries, was calculated as 957 000 euros. Conclusions: It is recommended that MRI should only be used in patients in whom there are clinical difficulties in terms of diagnosing wrist ligament injuries. It is suggested that patients with suspected wrist ligament injuries should be referred directly to an experienced hand surgeon, capable of performing a standardised wrist examination and, when needed, diagnostic arthroscopy and final treatment. The proposed algorithm for the diagnosis and treatment of suspected wrist ligament injuries presented in the present study could save time for the patient and for the radiology departments, as well as reducing costs. The ability to implement the early and appropriate treatment of acute ligament injuries could be improved at the same time.

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