Comparison of MRI, CT and bone scintigraphy for suspected scaphoid fractures
Purpose The best diagnostic modality for confirmation of the diagnosis of a scaphoid fracture that is not visible on the initial radiograph (occult scaphoid fracture) is still subject of debate. The aim of this study was to compare the accuracy of magnetic resonance imaging (MRI), computed tomograph...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2016-12, Vol.42 (6), p.725-731 |
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| container_title | European journal of trauma and emergency surgery (Munich : 2007) |
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| creator | de Zwart, A. D. Beeres, F. J. P. Rhemrev, S. J. Bartlema, K. Schipper, I. B. |
| description | Purpose
The best diagnostic modality for confirmation of the diagnosis of a scaphoid fracture that is not visible on the initial radiograph (occult scaphoid fracture) is still subject of debate. The aim of this study was to compare the accuracy of magnetic resonance imaging (MRI), computed tomography (CT) and bone scintigraphy (BS) for the diagnosis of these occult scaphoid fractures.
Patients and methods
In a study period of 12 months, 33 consecutive patients with a clinically suspected scaphoid fracture without a fracture on the scaphoid radiographs were evaluated with MRI, CT and BS. In case of a discrepancy between the diagnostic modalities, the final diagnosis was based on standardised follow-up with clinical examination and a repeated radiograph.
Results
Three of the 33 patients had a scaphoid fracture. MRI missed one scaphoid fracture and did not over-diagnose. CT missed two scaphoid fractures and did not over-diagnose. BS missed no scaphoid fractures and over-diagnosed one scaphoid fracture in a patient with a fracture of the trapezium.
Conclusion
This study shows that neither MRI, nor CT and BS are 100 % accurate in diagnosing occult scaphoid fractures. MRI and CT miss fractures, and BS tends to over-diagnose. The specific advantages and limitations of each diagnostic modality should be familiar to the treating physicians and taken into consideration during the diagnostic process. |
| doi_str_mv | 10.1007/s00068-015-0594-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826636565</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1826636565</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-44480a8ec44081701e23e15f4b27480a8c97946ec041c88ef041df0905de45ea3</originalsourceid><addsrcrecordid>eNp1kE1LAzEURYMoVqs_wI0E3LhwNN8zWUrxo1ARpK5DmnlTp7STMZlZ9N-b2lpEcPVC7nk34SB0QcktJSS_i4QQVWSEyoxILTJ9gE5ooXimtaCH-zPnA3Qa4yLBREl2jAZMSSlzpk_QZORXrQ119A32FX55G9_g0RTbpsQz3wCOrm66eh5s-7HGlQ849rEF10GZonTp6xJXwbquDxDP0FFllxHOd3OI3h8fpqPnbPL6NB7dTzLHc9ZlQoiC2AKcEKSgOaHAOFBZiRnLvxOncy0UOCKoKwqo0iwrooksQUiwfIiut71t8J89xM6s6uhgubQN-D4aWjCluJJKJvTqD7rwfWjS7xIlOJM5pyxRdEu54GMMUJk21Csb1oYSs1FttqpNUm02qo1OO5e75n62gnK_8eM2AWwLxBQ1cwi_nv639QuGjYb2</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1843257312</pqid></control><display><type>article</type><title>Comparison of MRI, CT and bone scintigraphy for suspected scaphoid fractures</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>de Zwart, A. D. ; Beeres, F. J. P. ; Rhemrev, S. J. ; Bartlema, K. ; Schipper, I. B.</creator><creatorcontrib>de Zwart, A. D. ; Beeres, F. J. P. ; Rhemrev, S. J. ; Bartlema, K. ; Schipper, I. B.</creatorcontrib><description>Purpose
The best diagnostic modality for confirmation of the diagnosis of a scaphoid fracture that is not visible on the initial radiograph (occult scaphoid fracture) is still subject of debate. The aim of this study was to compare the accuracy of magnetic resonance imaging (MRI), computed tomography (CT) and bone scintigraphy (BS) for the diagnosis of these occult scaphoid fractures.
Patients and methods
In a study period of 12 months, 33 consecutive patients with a clinically suspected scaphoid fracture without a fracture on the scaphoid radiographs were evaluated with MRI, CT and BS. In case of a discrepancy between the diagnostic modalities, the final diagnosis was based on standardised follow-up with clinical examination and a repeated radiograph.
Results
Three of the 33 patients had a scaphoid fracture. MRI missed one scaphoid fracture and did not over-diagnose. CT missed two scaphoid fractures and did not over-diagnose. BS missed no scaphoid fractures and over-diagnosed one scaphoid fracture in a patient with a fracture of the trapezium.
Conclusion
This study shows that neither MRI, nor CT and BS are 100 % accurate in diagnosing occult scaphoid fractures. MRI and CT miss fractures, and BS tends to over-diagnose. The specific advantages and limitations of each diagnostic modality should be familiar to the treating physicians and taken into consideration during the diagnostic process.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-015-0594-9</identifier><identifier>PMID: 26555729</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Aged ; Casts, Surgical ; Comparative studies ; Critical Care Medicine ; Emergency Medicine ; Female ; Fractures ; Fractures, Bone - diagnostic imaging ; Fractures, Bone - therapy ; Humans ; Intensive ; Magnetic Resonance Imaging ; Male ; Medical diagnosis ; Medical imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Positron-Emission Tomography ; Radiopharmaceuticals ; Scaphoid Bone - diagnostic imaging ; Scaphoid Bone - injuries ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Technetium Tc 99m Medronate - analogs & derivatives ; Tomography, X-Ray Computed ; Traumatic Surgery</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2016-12, Vol.42 (6), p.725-731</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><rights>European Journal of Trauma and Emergency Surgery is a copyright of Springer, 2016.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-44480a8ec44081701e23e15f4b27480a8c97946ec041c88ef041df0905de45ea3</citedby><cites>FETCH-LOGICAL-c372t-44480a8ec44081701e23e15f4b27480a8c97946ec041c88ef041df0905de45ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-015-0594-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-015-0594-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26555729$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Zwart, A. D.</creatorcontrib><creatorcontrib>Beeres, F. J. P.</creatorcontrib><creatorcontrib>Rhemrev, S. J.</creatorcontrib><creatorcontrib>Bartlema, K.</creatorcontrib><creatorcontrib>Schipper, I. B.</creatorcontrib><title>Comparison of MRI, CT and bone scintigraphy for suspected scaphoid fractures</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>Purpose
The best diagnostic modality for confirmation of the diagnosis of a scaphoid fracture that is not visible on the initial radiograph (occult scaphoid fracture) is still subject of debate. The aim of this study was to compare the accuracy of magnetic resonance imaging (MRI), computed tomography (CT) and bone scintigraphy (BS) for the diagnosis of these occult scaphoid fractures.
Patients and methods
In a study period of 12 months, 33 consecutive patients with a clinically suspected scaphoid fracture without a fracture on the scaphoid radiographs were evaluated with MRI, CT and BS. In case of a discrepancy between the diagnostic modalities, the final diagnosis was based on standardised follow-up with clinical examination and a repeated radiograph.
Results
Three of the 33 patients had a scaphoid fracture. MRI missed one scaphoid fracture and did not over-diagnose. CT missed two scaphoid fractures and did not over-diagnose. BS missed no scaphoid fractures and over-diagnosed one scaphoid fracture in a patient with a fracture of the trapezium.
Conclusion
This study shows that neither MRI, nor CT and BS are 100 % accurate in diagnosing occult scaphoid fractures. MRI and CT miss fractures, and BS tends to over-diagnose. The specific advantages and limitations of each diagnostic modality should be familiar to the treating physicians and taken into consideration during the diagnostic process.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Casts, Surgical</subject><subject>Comparative studies</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Female</subject><subject>Fractures</subject><subject>Fractures, Bone - diagnostic imaging</subject><subject>Fractures, Bone - therapy</subject><subject>Humans</subject><subject>Intensive</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Positron-Emission Tomography</subject><subject>Radiopharmaceuticals</subject><subject>Scaphoid Bone - diagnostic imaging</subject><subject>Scaphoid Bone - injuries</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Technetium Tc 99m Medronate - analogs & derivatives</subject><subject>Tomography, X-Ray Computed</subject><subject>Traumatic Surgery</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kE1LAzEURYMoVqs_wI0E3LhwNN8zWUrxo1ARpK5DmnlTp7STMZlZ9N-b2lpEcPVC7nk34SB0QcktJSS_i4QQVWSEyoxILTJ9gE5ooXimtaCH-zPnA3Qa4yLBREl2jAZMSSlzpk_QZORXrQ119A32FX55G9_g0RTbpsQz3wCOrm66eh5s-7HGlQ849rEF10GZonTp6xJXwbquDxDP0FFllxHOd3OI3h8fpqPnbPL6NB7dTzLHc9ZlQoiC2AKcEKSgOaHAOFBZiRnLvxOncy0UOCKoKwqo0iwrooksQUiwfIiut71t8J89xM6s6uhgubQN-D4aWjCluJJKJvTqD7rwfWjS7xIlOJM5pyxRdEu54GMMUJk21Csb1oYSs1FttqpNUm02qo1OO5e75n62gnK_8eM2AWwLxBQ1cwi_nv639QuGjYb2</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>de Zwart, A. D.</creator><creator>Beeres, F. J. P.</creator><creator>Rhemrev, S. J.</creator><creator>Bartlema, K.</creator><creator>Schipper, I. 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D. ; Beeres, F. J. P. ; Rhemrev, S. J. ; Bartlema, K. ; Schipper, I. B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-44480a8ec44081701e23e15f4b27480a8c97946ec041c88ef041df0905de45ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Casts, Surgical</topic><topic>Comparative studies</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Female</topic><topic>Fractures</topic><topic>Fractures, Bone - diagnostic imaging</topic><topic>Fractures, Bone - therapy</topic><topic>Humans</topic><topic>Intensive</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Positron-Emission Tomography</topic><topic>Radiopharmaceuticals</topic><topic>Scaphoid Bone - diagnostic imaging</topic><topic>Scaphoid Bone - injuries</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Technetium Tc 99m Medronate - analogs & derivatives</topic><topic>Tomography, X-Ray Computed</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Zwart, A. D.</creatorcontrib><creatorcontrib>Beeres, F. J. P.</creatorcontrib><creatorcontrib>Rhemrev, S. J.</creatorcontrib><creatorcontrib>Bartlema, K.</creatorcontrib><creatorcontrib>Schipper, I. 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D.</au><au>Beeres, F. J. P.</au><au>Rhemrev, S. J.</au><au>Bartlema, K.</au><au>Schipper, I. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of MRI, CT and bone scintigraphy for suspected scaphoid fractures</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>42</volume><issue>6</issue><spage>725</spage><epage>731</epage><pages>725-731</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><abstract>Purpose
The best diagnostic modality for confirmation of the diagnosis of a scaphoid fracture that is not visible on the initial radiograph (occult scaphoid fracture) is still subject of debate. The aim of this study was to compare the accuracy of magnetic resonance imaging (MRI), computed tomography (CT) and bone scintigraphy (BS) for the diagnosis of these occult scaphoid fractures.
Patients and methods
In a study period of 12 months, 33 consecutive patients with a clinically suspected scaphoid fracture without a fracture on the scaphoid radiographs were evaluated with MRI, CT and BS. In case of a discrepancy between the diagnostic modalities, the final diagnosis was based on standardised follow-up with clinical examination and a repeated radiograph.
Results
Three of the 33 patients had a scaphoid fracture. MRI missed one scaphoid fracture and did not over-diagnose. CT missed two scaphoid fractures and did not over-diagnose. BS missed no scaphoid fractures and over-diagnosed one scaphoid fracture in a patient with a fracture of the trapezium.
Conclusion
This study shows that neither MRI, nor CT and BS are 100 % accurate in diagnosing occult scaphoid fractures. MRI and CT miss fractures, and BS tends to over-diagnose. The specific advantages and limitations of each diagnostic modality should be familiar to the treating physicians and taken into consideration during the diagnostic process.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>26555729</pmid><doi>10.1007/s00068-015-0594-9</doi><tpages>7</tpages></addata></record> |
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| identifier | ISSN: 1863-9933 |
| ispartof | European journal of trauma and emergency surgery (Munich : 2007), 2016-12, Vol.42 (6), p.725-731 |
| issn | 1863-9933 1863-9941 |
| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Adolescent Adult Aged Casts, Surgical Comparative studies Critical Care Medicine Emergency Medicine Female Fractures Fractures, Bone - diagnostic imaging Fractures, Bone - therapy Humans Intensive Magnetic Resonance Imaging Male Medical diagnosis Medical imaging Medicine Medicine & Public Health Middle Aged Original Article Positron-Emission Tomography Radiopharmaceuticals Scaphoid Bone - diagnostic imaging Scaphoid Bone - injuries Sports Medicine Surgery Surgical Orthopedics Technetium Tc 99m Medronate - analogs & derivatives Tomography, X-Ray Computed Traumatic Surgery |
| title | Comparison of MRI, CT and bone scintigraphy for suspected scaphoid fractures |
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