Cone-Beam CT in diagnosis of scaphoid fractures

Edlund, Rolf; Skorpil, Mikael; Lapidus, Gunilla; Bäcklund, Jenny

doi:10.1007/s00256-015-2290-6

Cited by 43 publications

(33 citation statements)

References 27 publications

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“…Our findings are consistent with a recent study by Edlund et al [28], who found that CBCT was a reliable examination for the diagnosis of scaphoid fracture. However, in their study, not every patient underwent both types of imaging exams (CBCT and MRI), and in the MRI was carried out 15 days after the CBCT.…”

Section: Discussionsupporting

confidence: 94%

Diagnostic value of cone beam computed tomography (CBCT) in occult scaphoid and wrist fractures

Borel

Larbi

Delclaux

et al. 2017

European Journal of Radiology

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Section: Discussionsupporting

confidence: 94%

Diagnostic value of cone beam computed tomography (CBCT) in occult scaphoid and wrist fractures

Borel

Larbi

Delclaux

et al. 2017

European Journal of Radiology

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“…The additional fractures mainly included a higher number of (avulsion) fractures of the proximal carpal row, with a higher accuracy for carpal injury than previously published [ 12 ]. Recent studies have described this pattern of additional diagnoses also for cone beam CT [ 17 ] and even for sonography [ 18 ]. However, in contrast to most of these studies on selected patient groups, this was the first study that prospectively investigated CT as an imaging tool in all patients with clinical suspicion of wrist fractures, with a multiobserver study on treatment impact.…”

Section: Discussionmentioning

confidence: 99%

Single-shot CT after wrist trauma: impact on detection accuracy and treatment of fractures

et al. 2018

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Objective To evaluate accuracy of fracture detection and therapeutic impact of a single-shot CT protocol as a primary imaging tool in all patients with clinical suspicion of wrist injury, and evaluate the resulting impact on therapy. Materials and methods We performed a single-institution study on all patients with suspicion of fractures of the wrist and carpus. All patients underwent conventional radiography, thereafter single-shot wrist CT, and then 1-year follow-up. Physicians and radiologists prospectively scored likelihood of fracture presence on a five-point scale before and after CT. Three surgeons proposed a treatment regimen (functional, cast, reduction, or operative) based on clinical and radiological data, first with knowledge of conventional radiography, and then with knowledge of CT. The reference standard for fracture presence was based on all data. We performed receiver operating characteristic (ROC) analyses and calculated proportion of wrists with treatment changes due to CT imaging. Results Ninety-eight patients participated (63% female, mean age 53, range, 18–87 years old) with 100 wrist CTs. Conventional radiography detected true-positive fractures in 45, and CT in 61 wrists. The areas under the curve for fracture detection were 0.85 (95% CI 0.77–0.93) for conventional radiography and 0.97 (95% CI 0.93–1.00) for CT. Treatment changed in 24 (24%, 95% CI 16–33%) - 31 (31%, 95% CI 23–41%) wrists, mostly involving a decrease in the rate of cast immobilization. Conclusions Single-shot CT in patients with clinical suspicion of wrist injury increases accuracy of fracture detection. This has a significant impact therapy in this population, mainly on cast immobilization. Trial Registration We registered the study at www.clinicaltrials.gov , NL43482.091.13.

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“…CBCT has excellent sensitivity for the detection of small bone and joint trauma. MRI remains the gold standard for the evaluation of occult fractures, 77 but accessibility and potential contraindications mean that CBCT can play an important role in the evaluation of patients with suspected fractures and normal radiographs, in particular in sites with overlapping bony structures such as the wrist or foot and can remove the need for MRI at a later date 77 (►Fig. 7).…”

Section: Cone Beam Ctmentioning

confidence: 99%

Musculoskeletal Imaging: Current Practice and Future Directions

Farrell

Adams

Walsh

et al. 2018

Semin Musculoskelet Radiol

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Musculoskeletal (MSK) radiology plays a crucial role in the diagnosis and management of MSK disorders and has rapidly expanded in tandem with advances in technology and improved access to imaging. Although anatomical imaging remains the mainstay of MSK radiology, significant progress has been made in functional and molecular imaging as well as in hybrid imaging with an expanding armament of technologies becoming available or in development. A vast array of research is occurring in MSK imaging, and this review article highlights some of the most promising current and future clinical applications in development in each of the major imaging modalities. Identifying the clinical utility of these technologies in an era of rising health care costs is an important challenge for MSK radiologists.

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Cone-Beam CT in diagnosis of scaphoid fractures

Abstract: CBCT is a superior alternative to radiography, entailing more accurate diagnoses of carpal region fractures, and thereby requiring fewer follow-up MRI examinations. However, CBCT cannot be used to exclude scaphoid fractures, since MRI identified additional occult scaphoid fractures.

Cited by 43 publications

References 27 publications

Diagnostic value of cone beam computed tomography (CBCT) in occult scaphoid and wrist fractures

Diagnostic value of cone beam computed tomography (CBCT) in occult scaphoid and wrist fractures

Single-shot CT after wrist trauma: impact on detection accuracy and treatment of fractures

Musculoskeletal Imaging: Current Practice and Future Directions

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