Imaging in crush injury: a spectrum of findings in survivors of the twin earthquakes on February 6, 2023


ERDEMİR A. G., İDİLMAN İ. S., Çifçi G. Ç., YILDIZ A. E., DEMİRKAZIK F., ONUR M. R., ...Daha Fazla

Emergency Radiology, cilt.30, sa.4, ss.513-523, 2023 (ESCI) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 30 Sayı: 4
  • Basım Tarihi: 2023
  • Doi Numarası: 10.1007/s10140-023-02147-4
  • Dergi Adı: Emergency Radiology
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.513-523
  • Anahtar Kelimeler: Crush injury (D000071576), Crush syndrome (D003444), Magnetic resonance imaging (D008279), Multidetector computed tomography (D061330), Rhabdomyolysis (D012206)
  • Hacettepe Üniversitesi Adresli: Evet

Özet

On February 6, two major earthquakes with magnitudes of 7.8 and 7.7 on the Richter scale hit Turkey and Northern Syria causing more than 50,000 deaths. In the immediate aftermath of the earthquakes, our major tertiary medical referral center received dozens of cases of crush syndrome, presenting with a variety of imaging findings. Crush syndrome is characterized by hypovolemia, hyperkalemia, and myoglobinuria that can lead to rapid death of victims, despite their survival of staying under wreckage for days. The typical triad of crush syndrome consists of the acute tubular necrosis, paralytic ileus, and third-space edema. In this article, we focus primarily on characteristic imaging findings of earthquake-related crush syndrome and divided them into two distinct subsections: myonecrosis, rapid hypovolemia, excessive third-space edema, acute tubular necrosis, and paralytic ileus, which are directly related to crush syndrome, and typical accompanying findings of earthquake-related crush syndrome. Lower extremity compression in earthquake survivors results in the typical third-space edema. In addition to the lower extremities, other skeletal muscle regions are also affected, especially rotator muscles, trapezius, and pectoral muscles. Although it may be relatively easy to better detect myonecrosis with contrast-enhanced CT scans, changing the windowing of the images may be helpful.