Comparison of the diagnostic value of clinical examination versus results of radiography in the upper and lower limb fractures

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Taghiloo Dariush; Ganjkhanloo Asadollah; Salehi Mohsen; Perseh Lida; Soltani Mohammad; Mohammadi Fatemeh; Karvar Mohsen; Mohammadi Maryam

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Journal Paper

Paper Information

Journal: JOURNAL OF MEDICINAL AND PHARMACEUTICAL CHEMISTRY RESEARCH Year:2025 | Volume:7 | Issue:2 Page(s): 275-281

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Title

Comparison of the diagnostic value of clinical examination versus results of radiography in the upper and lower limb fractures

Author(s)

Keywords

Physical exam

Limb fracture

Diagnosis

Radiography

Emergency Department

Abstract

X-ray is routinely requested for trauma patients hospitalized at an emergency room (ER) following a review of therapeutic history and physical examination, which is usually reported to be normal. The question is the extent to which X-ray is effective in diagnosing and determining the treatment plan of limb trauma patients. In this cross-sectional study, the study population consisted of 100 patients with trauma referred to the ED of Mousavi Hospital, Zanjan, Iran, from August 2019 to November 2019 who were suspected of limbs injuries based on the trauma mechanism and the patient's complaints. The census sampling method and the inclusion and exclusion criteria were used to select patients. According to the present study of 100 patients, 38% were females, and 62% were males. 51% of patients had upper limb injuries, and 49% had lower limb injuries. Thirty-four percent of the patients were treated surgically and 66% with non-surgical methods. Study findings, unlike the graphic test, the receiver operating characteristic (ROC) curve for the clinical examination test was estimated at 0.78, suggesting the clinical examination test has little diagnostic value in contrast to the radiography testing as the gold standard. Given that the gold standards for diagnosing patients with trauma are 98% for radiography and 100% for CT scans and other diagnostic tools, the present study’s results confirmed that standard clinical examinations compared with the gold standard have little diagnostic value. Other diagnostic procedures such as X-rays are required to diagnose injured patients, especially those subjected to lower and upper limb trauma.

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