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Skeletal Radiology

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01-02-2016 | Scientific Article

Cone-Beam CT in diagnosis of scaphoid fractures

Authors: Rolf Edlund, Mikael Skorpil, Gunilla Lapidus, Jenny Bäcklund

Published in: Skeletal Radiology | Issue 2/2016

Abstract

Objective

This prospective study investigated the sensitivity of cone beam computed tomography (CBCT), a low dose technique recently made available for extremity examinations, in detecting scaphoid fractures. Magnetic resonance imaging (MRI) was used as gold standard for scaphoid fractures.

Materials and methods

A total of 95 patients with a clinically suspected scaphoid fracture were examined with radiography and CBCT in the acute setting. A negative CBCT exam was followed by an MRI within 2 weeks. When a scaphoid fracture was detected on MRI a new CBCT was performed.

Results

Radiography depicted seven scaphoid fractures, all of which were also seen with CBCT. CBCT detected another four scaphoid fractures. With MRI another five scaphoid fractures were identified that were not seen with radiography or with CBCT. These were also not visible on the reexamination CBCT. Sensitivity for radiography was 44, 95 % confidence interval 21–69 %, and for CBCT 69 %, 95 % confidence interval 41–88 % (p = 0.12). Several non-scaphoid fractures in the carpal region were identified, radiography and CBCT depicted 7 and 34, respectively (p < 0.0001).

Conclusion

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.

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Title: Cone-Beam CT in diagnosis of scaphoid fractures
Authors: Rolf Edlund
Mikael Skorpil
Gunilla Lapidus
Jenny Bäcklund
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: Skeletal Radiology / Issue 2/2016
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-015-2290-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cone-Beam CT in diagnosis of scaphoid fractures

Abstract

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

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