The utility of cross‐sectional imaging in the management of suspected scaphoid fractures

Wijetunga, Asanka; Tsang, Venessa; Giuffrè, Bruno

doi:10.1002/jmrs.302

Cited by 13 publications

(9 citation statements)

References 22 publications

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“…The study of Wijetunga et al [15] matches with our study results that CT and MRI have equal sensitivity to displaced and nondisplaced fractures. The study preferred MRI due to its reduced radiation risk.…”

Section: Discussionsupporting

confidence: 91%

Comparative Study Between Role of Computed Tomography and Magnetic Resonance Imaging in Scaphoid Fracture Diagnosis

Desouky¹,

Wahdan²,

Ella³

2021

IJHEP

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Background: Fractures of the scaphoid are the second most common fractures of the upper limb after distal radius fractures. Rapid and accurate diagnosis is needed, because delayed initiation of therapy increases the risk of complications such as non-union and avascular necrosis. Objectives: To compare between the diagnostic accuracies of Computed Tomography and Magnetic Resonance Imaging in detecting scaphoid fractures and its complications. Methods: This study was carried out on 30 patients presented to private Hand clinic from October 2018 to December 2019, with clinical symptoms of tenderness in the anatomic snuffbox after wrist trauma and suspected to have scaphoid fracture in the plane X-ray. They were invited to enroll in a comparison of CT and MRI with regard to their diagnostic utility. Results: The mean age for study participants was 31.8 years (SD = 12.6 years). Nineteen patients (66.7%) had horizontal fractures, 10 had oblique structures (33.3). The MDCT showed that 29 patients had cortical fractures, MRI showed that 27 had cortical fractures, 2 patients had mixed fractures and one patient had a trabecular fracture. Conclusion: Multidetector CT had the superiority over MRI in detection of cortical involvement in scaphoid fractures but MDCT was inferior to MRI in detection of trabecular scaphoid fractures. MRI was superior to MDCT in early detection of stage I Scaphoid non-union advanced collapse. MRI was superior to CT in early detection of avascular necrosis of proximal segment of scaphoid bone.

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Section: Discussionsupporting

confidence: 91%

Comparative Study Between Role of Computed Tomography and Magnetic Resonance Imaging in Scaphoid Fracture Diagnosis

Desouky¹,

Wahdan²,

Ella³

2021

IJHEP

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“…[37][38][39] This, together with the large number of false positives, implies that follow-up radiographs cannot be considered as a reference in the diagnosis of scaphoid fractures. 36,38,40,41 Interobserver agreement for MRI assessment of scaphoid fracture by four and five observers in cohorts of 79 and 64 patients, with a similar percentage of scaphoid fractures among those suspected clinically as in our study, was κ = 0.67 and κ = 0.44 respectively, representing moderate to substantial agreement. 42,43 Beeres et al, 44 in a study in which bone scans of both wrists of 100 patients with a clinically-suspected scaphoid fracture on at least one side were analyzed by three observers, found substantial agreement, κ = 0.61 to 0.80, for the diagnosis of a scaphoid fracture and for the diagnosis of other fractures.…”

Section: Discussionsupporting

confidence: 65%

The interobserver reliability of the diagnosis and classification of scaphoid fractures using high-resolution peripheral quantitative CT

Daniels

Wyers

Janzing³

et al. 2020

The Bone & Joint Journal

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Aims Besides conventional radiographs, the use of MRI, CT, and bone scintigraphy is frequent in the diagnosis of a fracture of the scaphoid. However, which techniques give the best results remain unknown. The investigation of a new imaging technique initially requires an analysis of its precision. The primary aim of this study was to investigate the interobserver agreement of high-resolution peripheral quantitative CT (HR-pQCT) in the diagnosis of a scaphoid fracture. A secondary aim was to investigate the interobserver agreement for the presence of other fractures and for the classification of scaphoid fracture. Methods Two radiologists and two orthopaedic trauma surgeons evaluated HR-pQCT scans of 31 patients with a clinically-suspected scaphoid fracture. The observers were asked to determine the presence of a scaphoid or other fracture and to classify the scaphoid fracture based on the Herbert classification system. Fleiss kappa statistics were used to calculate the interobserver agreement for the diagnosis of a fracture. Intraclass correlation coefficients (ICCs) were used to assess the agreement for the classification of scaphoid fracture. Results A total of nine (29%) scaphoid fractures and 12 (39%) other fractures were diagnosed in 20 patients (65%) using HR-pQCT across the four observers. The interobserver agreement was 91% for the identification of a scaphoid fracture (95% confidence interval (CI) 0.76 to 1.00) and 80% for other fractures (95% CI 0.72 to 0.87). The mean ICC for the classification of a scaphoid fracture in the seven patients diagnosed with scaphoid fracture by all four observers was 73% (95% CI 0.42 to 0.94). Conclusion We conclude that the diagnosis of scaphoid and other fractures is reliable when using HR-pQCT in patients with a clinically-suspected fracture. Cite this article: Bone Joint J 2020;102-B(4):478–484.

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“…A similar approach was recommended by Wijetunga et al in a study reported in the current issue of Journal of Medical Radiation Sciences. The authors conducted a retrospective review of patients with suspected scaphoid fractures presenting to an urban hospital.…”

mentioning

confidence: 84%

The role of magnetic resonance imaging in the evaluation of scaphoid fractures

Peh

2019

J of Medical Radiation Sci

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The utility of cross‐sectional imaging in the management of suspected scaphoid fractures

Cited by 13 publications

References 22 publications

Comparative Study Between Role of Computed Tomography and Magnetic Resonance Imaging in Scaphoid Fracture Diagnosis

Comparative Study Between Role of Computed Tomography and Magnetic Resonance Imaging in Scaphoid Fracture Diagnosis

The interobserver reliability of the diagnosis and classification of scaphoid fractures using high-resolution peripheral quantitative CT

The role of magnetic resonance imaging in the evaluation of scaphoid fractures

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