Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs

Abstract

Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs.

Diagnostic accuracy of history taking, physical examination and imaging for phalangeal, metacarpal and carpal fractures: a systematic review update

“…Key factors in a meta-analysis are the number and the methodological quality of the included studies and the degree of heterogeneity in their estimates of diagnostic accuracy [42]. Heterogeneity in diagnostic test accuracy reviews is expected and the possibilities of performing meta-regression analyses will depend on the number of studies available for a specific index test that provide sufficient information [39]. The data from the included studies were combined when studies showed no limitations according to QUADAS-2 and had no other forms of bias (e.g.…”

“…However, MRI is more specific and better for confirming scaphoid fractures when compared to BS. According to the Cochrane review of Mallee et al, statistically BS is the best diagnostic modality for establishing a definitive diagnosis in clinically suspected fractures when radiographs appear normal, but the number of overtreated patients is substantially lower with CT and MRI [39]. Moreover, physicians must keep in mind that BS is more invasive than the other modalities.…”

“…Currently, there are several systematic reviews available on the diagnostic accuracy of tests for the diagnosis of hand and wrist fractures, as presented in Table 1 [32][33][34][35][36][37][38][39]. Of these, only the review by Carpenter et al used 'history' as a keyword in their search terms, but they could not find studies assessing the diagnostic accuracy of history for scaphoid fractures [32].…”

“…Of these, only the review by Carpenter et al used 'history' as a keyword in their search terms, but they could not find studies assessing the diagnostic accuracy of history for scaphoid fractures [32]. All the available systematic reviews only examined diagnostic tests for scaphoid fractures [32][33][34][35][36][37][38][39], while in practice it is often not quite clear during the diagnostic process which hand or wrist anatomical structure or tissue (soft tissue or bone) is affected. Moreover, these reviews focused predominantly on imaging as a diagnostic tool, while in clinical practice a diagnosis is mainly made on history taking and physical examination.…”

Exploring the use of extremity cone beam computed tomography (CBCT) technology in the emergency department (ED) for patients with suspected scaphoid fracture

“…The benefits of other imaging modalities has been widely researched and has confirmed high sensitivity and specificity values for both magnetic resonance imaging (MRI) and computed tomography (CT). [13][14][15][16][17] In 2016 NICE published guidance on the imaging of suspected scaphoid fractures 4 , which concluded that organisations should consider MRI as the first-line imaging investigation. It has the advantage of not using ionising radiation, and also provides excellent visualisation of other bony or soft tissue injuries.…”