Carpus

Comparison of CT and MRI for Diagnosis of Suspected Scaphoid Fractures

Mallee W, Doornberg JN, Ring D, et al (Academic Med Ctr of Amsterdam, The Netherlands; Massachusetts General Hosp, Boston) J Bone Joint Surg Am 93:20-28, 2011^§

Abstract

Background

There is no consensus on the optimum imaging method to use to confirm the diagnosis of true scaphoid fractures among patients with suspected scaphoid fractures. This study tested the null hypothesis that computed tomography (CT) and magnetic resonance imaging (MRI) have the same diagnostic performance characteristics for the diagnosis of scaphoid fractures.

Methods

Thirty-four consecutive patients with a suspected scaphoid fracture (tenderness of the scaphoid and normal radiographic findings after a fall on the outstretched hand) underwent CT and MRI within ten days after a wrist injury. The reference standard for a true fracture of the scaphoid was six-week follow-up radiographs in four views. A panel including surgeons and radiologists came to a consensus diagnosis for each type of imaging. The images were considered in a randomly ordered, blinded fashion, independent of the other types of imaging. We calculated sensitivity, specificity, and accuracy as well as positive and negative predictive values.

Results

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