Expert consensus on X-ray arthrography techniques for pediatric elbow injuries
Elbow injuries are among the most common injuries in children.The unique anatomical features of the pediatric elbows,characterized by abundant cartilaginous tissue,make it difficult to adequately visualize the articular cartilage on conventional X-rays,leading to challenges in radiographic interpretation.Variations in the timing of secondary ossification centers in pediatric elbow joints lead to differences in the assessment of elbow injuries by orthopedic surgeons,increasing the risk of misdiagnosis and missed diagnosis,and may finally affect the accurate evaluation of treatment outcomes.Consequently,establishing an early,accurate,and effective assessment method is vital for the diagnosis and treatment of pediatric elbow injuries.Arthrography effectively supplements the limitations of conventional X-ray imaging in cartilage.Therefore,this technique has gradually gained popularity for diagnosing and evaluating the treatment outcomes of pediatric elbow injuries,aiming to improve diagnostic accuracy and treatment outcomes.Despite the widespread use of elbow joint arthrography,there are significant differences in operation standards and habits among different regions and operators,which severely affects the uniformity and reliability of the arthrographic effects.At present,there is an urgent need to establish a standardized and effective elbow arthrography technique.Therefore,to ensure consistent and reliable imaging results during elbow joint arthrography,reduce unnecessary repeated procedures,and minimize complications,the"Expert Consensus on X-ray Angiography Techniques in Pediatric Elbow Injuries"was developed based on literature review and survey research.This consensus systematically summarizes the challenges in the diagnosis and treatment of pediatric fractures around the elbow and elaborates in detail on the application of intraoperative X-ray angiography in addressing these issues.Guided by clinical problems,seven key issues are identified:① the concept of intraoperative elbow arthrography;② indications for intraoperative elbow X-ray angiography;③ techniques for intraoperative elbow X-ray angiography;④ choice of contrast agents;⑤ the safety of contrast agents;⑥ whether skin testing is needed before the use of contrast agents;⑦ whether contrast agents need to be diluted.This expert consensus aims to guide and standardize the clinical application of elbow arthrography in pediatric elbow injuries,thereby promoting its widespread adoption and development within the field of orthopedics.
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