دورية أكاديمية
The value of additional carpal box radiographs in suspected scaphoid fracture.
العنوان: | The value of additional carpal box radiographs in suspected scaphoid fracture. |
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المؤلفون: | Roolker L; Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands., Tiel-van Buul MM, Bossuyt PP, Dijkstra PF, van Grieken HJ, Broekhuizen TH |
المصدر: | Investigative radiology [Invest Radiol] 1997 Mar; Vol. 32 (3), pp. 149-53. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0045377 Publication Model: Print Cited Medium: Print ISSN: 0020-9996 (Print) Linking ISSN: 00209996 NLM ISO Abbreviation: Invest Radiol Subsets: MEDLINE |
أسماء مطبوعة: | Publication: 1998- : Hagerstown, MD : Lippincott Williams & Wilkins Original Publication: Philadelphia. |
مواضيع طبية MeSH: | Carpal Bones/*diagnostic imaging , Fractures, Bone/*diagnostic imaging , Radiography/*instrumentation, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carpal Bones/injuries ; Child ; Female ; Humans ; Male ; Middle Aged ; Observer Variation |
مستخلص: | Rationale and Objectives: Carpal Box (CB) radiographs, transverse and longitudinal, produce elongated and magnified views of the carpus. These radiographs can be used after carpal injury, in addition to conventional scaphoid x-rays. In this study, the use of CB radiographs was evaluated in patients with possible scaphoid fracture. Methods: Seventy-one consecutive patients who presented at the First Aid department from May 1994 to May 1995 were included. All patients were examined for scaphoid fracture after a fall on the out-stretched hand. If a scaphoid fracture was seen on the scaphoid x-rays, patients were immobilized. If the x-rays remained negative or dubious for fracture, additional transverse and longitudinal CB radiographs were obtained. If CB radiographs remained negative or inconclusive, patients were referred for three-phase bone scintigraphy. The results of independent and masked judgment by three different observers were used for an inter- and intraobserver analysis. Results: Twenty of 71 patients initially showed a scaphoid fracture on the conventional scaphoid x-rays, 41 were negative, and 10 inconclusive. All 41 negative patients remained negative on CB radiograph; however, the bone scintigraphy was positive for scaphoid fracture in 11 patients and in 9 patients a hot spot elsewhere in the carpus was found. Of the 10 patients with inconclusive x-rays, 2 showed a clear fracture of the scaphoid on CB radiograph, 5 were negative, and 3 remained inconclusive. The agreement between observers, calculated in kappa values, was highest in CB radiographs. Conclusions: In the diagnosis of scaphoid fracture, Carpal Box radiography is of limited value in patients with clinically suspected scaphoid fracture. In two of 10 patients with initial dubious scaphoid x-ray, bone scintigraphy can be avoided. Furthermore, the reliability of the interpretation of the radiographs is increased by additional Carpal Box radiography. |
تواريخ الأحداث: | Date Created: 19970301 Date Completed: 19970508 Latest Revision: 20190822 |
رمز التحديث: | 20240627 |
DOI: | 10.1097/00004424-199703000-00003 |
PMID: | 9055127 |
قاعدة البيانات: | MEDLINE |
تدمد: | 0020-9996 |
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DOI: | 10.1097/00004424-199703000-00003 |