This article is more than 5 years old. Information may no longer be current.
Researchers focus on injuries, radiologic imaging based on Boston Marathon bombing
Click Here to Manage Email Alerts
Treatment protocol, including radiologic imaging, and knowledge about blast injuries similar to those sustained by victims at the Boston Marathon bombing can benefit rheumatologists or other specialists who may have to serve as first responders, a recent report states.
“Civilian radiologists are not used to taking care of patients of a terror blast,” researcher Ali Guermazi, MD, PhD, professor of radiology, Boston University School of Medicine, told Healio.com. “The article emphasizes the three major injuries that may happen in a powerful terror explosion: comminuted bone fracture, soft tissue damage and/or vascular injury. This is in addition to the presence of shrapnel.
Ali Guermazi
“Imaging is important in the diagnosis of these different entities and hence allows optimal and timely treatment of these lethal injuries.”
Extremity injuries were classified as:
- primary injuries from a blast wave, including extensive soft tissue damage, limb fractures and amputations
- secondary injuries from penetrating trauma caused by projectiles, including metallic fragments or glass
- tertiary injuries, including blunt or penetrating trauma, fractures and traumatic amputations when the victim’s body is displaced by blast wind
- quaternary injuries, including all other injuries
Radiography and CT modalities are used to assess blast injuries because images can be acquired quickly, and they can detect fractures and metallic and glass fragments.
The researchers also developed a flow chart for the diagnostic work-up of patients who sustained lower extremity injuries. Each extremity should be examined systematically for musculoskeletal, neurological and vascular injuries before radiography. Patients should be sent directly to operating rooms if they have severe soft tissue or bony destruction with clear vascular injuries. Portable radiography can be performed on patients pre-operatively.
“Rheumatologists who are not routinely involved in the care of acute trauma victims may be required [or] willing to act as a first responder … and may also see such patients later in the course of their recoveries from complex musculoskeletal injuries,” the researchers concluded. “Understanding of these initial injuries as elucidated by imaging will have a bearing on understanding the long-term consequences that these clinicians will be managing.”
Disclosure: The researchers report no relevant financial disclosures
Click Here to Manage Email Alerts