Dr. Tom Colletti
Purpose: The purpose of this article is to review the utilization of imaging modalities compared to the saline load test for the confirmation of traumatic arthrotomy (TA).
Method: A search of PubMed, Medline, and the Cochrane Library with search terms of traumatic arthrotomy, saline load test, computed tomography, and open fracture serve as the focus of this clinical literature review. There was a total of 20 review articles that served as the basis of this clinical review.
Results: The diagnosis of traumatic arthrotomy of the knee has been well-publicized with the utilization of computed tomography, but further studies are necessary for the evaluation of other joints. The saline load test continues to have validity in the assessment of TA, specifically with the understanding of the various volume loads required to achieve higher levels of specificity and sensitivity.
Conclusion: The saline load test is a frequently used procedure in the diagnosis of a penetrating joint injury. In certain body regions, imaging may be more reliable in the diagnosis of traumatic arthrotomy. The literature review has demonstrated that computed tomography (CT) has demonstrated superior results in specificity and sensitivity when compared to SLT for the evaluation of TA of the knee joint. Unfortunately, the utilization of imaging in other joint injuries appears to have inferior results when compared to SLT. It is important to understand that literature continues to lack consistency when identifying appropriate volume levels of saline to have a reliable test pending the joint being evaluated. The intraoperative evaluation for TA continues to be the gold standard in diagnosis but exposes patients to the risks associated with surgery. Further alternative research should be sought to minimize risks and improve patient outcomes.
Desgrange R. Battle Royale: Imaging versus Invasive Technique in the Diagnosis of Traumatic Arthrotomy. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2022; 4(4).
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