Does radiography still have a significant diagnostic role in evaluation of acute traumatic wrist injuries? A prospective comparative study

Basha, Mohammad Abd Alkhalik; Ismail, Ahmad Abdel Azim; Imam, Ahmed Hatem Farhan

doi:10.1007/s10140-017-1559-6

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…For our review, we only included the CT scaphoid sequences. 25 In recent studies, the interests of investigators focused more on the cone beam CT. 23,24 In contrast, similar findings were found on the different MRI sequences. According to Larribe et al, MRI contrast-(gadolinium) enhanced images showed highest sensitivity (83%) and specificity (100%) as compared to unenhanced sequences with 67 and 67%, respectively, which were statistically significant.…”

Section: Discussionsupporting

confidence: 77%

“…In comparison to previous systematic reviews, six additional studies were included. [23][24][25][26][27][28] Males were affected in 49.2% of cases and the mean age was 34.1 AE 5.7 years. The overall incidence of occult scaphoid fractures was 21.8% (standard deviation [SD] 9.81).…”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, we were not able to obtain true and false positive values from six studies and only the specificity and sensitivity were presented. 18,23,24,[29][30][31] Because of this absence, the predictive values-positive as well as negative (PPV and NPV)-were not accessible in four studies. 18,[29][30][31] Sensitivity was found to be highest in MRI at 94.2% (SD 10.7), followed by bone scintigraphy at 92.8% (SD 11.4).…”

Section: Resultsmentioning

confidence: 99%

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Systematic Review of Diagnosis of Clinically Suspected Scaphoid Fractures

Bäcker

Strauch

2019

Jnl Wrist Surg

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Background Scaphoid fracture accounts for approximately 15% of acute wrist fractures. Clinical examination and plain X-rays are commonly used to diagnose the fracture, but this approach may miss up to 16% of fractures in the absence of clear-cut lucent lines on plain radiographs. As such, additional imaging may be required. It is not clear which imaging modality is the best. The goal of this study is to summarize the current literature on scaphoid fractures to evaluate the sensitivity, specificity, and accuracy of four different imaging modalities. Case Description A systematic-review and meta-analysis was performed. The search term “scaphoid fracture” was used and all prospective articles investigating magnetic resonance imaging (MRI), computed tomography (CT), bone scintigraphy, and ultrasound were included. In total, 2,808 abstracts were reviewed. Of these, 42 articles investigating 51 different diagnostic tools in 2,507 patients were included. Literature Review The mean age was 34.1 ± 5.7 years, and the overall incidence of scaphoid fractures missed on X-ray and diagnosed on advanced imaging was 21.8%. MRI had the highest sensitivity and specificity for diagnosing scaphoid fractures, which were 94.2 and 97.7%, respectively, followed by CT scan with a sensitivity and specificity at 81.5 and 96.0%, respectively. The sensitivity and specificity of ultrasound were 81.5 and 77.4%, respectively. Significant differences between MRI, bone scintigraphy, CT, and ultrasound were identified. Clinical Relevance MRI has higher sensitivity and specificity than CT scan, bone scintigraphy, or ultrasound. Level of Evidence This is a Level II systematic review.

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Section: Discussionsupporting

confidence: 77%