False negative 16 detector multislice CT for scaphoid fracture

Groves, Ashley M.; Cheow, Heok; Balan, K K; Courtney, H. M.; Bearcroft, PW; Dixon, Adrian K.

doi:10.1259/bjr/55015850

Cited by 25 publications

(4 citation statements)

References 8 publications

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“…However, MRI is relatively expensive and not readily available acutely for outpatients in the National Health Service of the UK (Hansen et al, 2009). Multidetector CT relies on cortical and/or trabecular displacement to identify fractures and can produce false negative and positive results acutely (Beeres et al, 2008;Groves et al, 2005). Compared with MRI, it is superior for identifying occult cortical scaphoid fractures, but inferior for detecting solely trabecular injury (Memarsadeghi et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Early CT for suspected occult scaphoid fractures

Stevenson

Morley

Srivastava

et al. 2011

J Hand Surg Eur Vol

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In this study, the use of computed tomography (CT) early in the management of suspected occult scaphoid fractures was evaluated. We retrospectively reviewed the notes and radiology of patients who had scaphoid CT scans over the preceding 3 years. Eighty-four patients that had CT scans within 14 days from injury were identified. Of the CT scans, 64% (n = 54) excluded a fracture and these patients were promptly mobilized. No patients returned with any complications from this management. Overall, 36% of CT scans were abnormal (n = 30), 7% revealed occult scaphoid fractures, 18% revealed occult carpal fractures of the triquetrum, capitate, and lunate, respectively, and 5% revealed distal radius fractures. All patients diagnosed with fractures were successfully managed with plaster immobilization and there was one case of complex regional pain syndrome. Early CT alters therapeutic decision making in suspected occult fractures preventing unnecessary immobilization in a working population without increase in cost.

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Section: Discussionmentioning

confidence: 99%

Early CT for suspected occult scaphoid fractures

Stevenson

Morley

Srivastava

et al. 2011

J Hand Surg Eur Vol

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“…However, diagnosis of fracture on CT relies on the presence of cortical or trabecula Figure 3 PA radiographs of the wrist taken in (a) neutral and (b) ulna deviation. On ulna deviation the scaphoid 'extends' so that it's long axis lies perpendicular to the X-ray beam, thus appearing longer displacement at the site of injury and when no displacement is present CT can fail to identify injury which can be seen on MRI and bone scan (Groves et al, 2005b;Temple et al, 2005).…”

Section: Diagnosismentioning

confidence: 99%

Acute scaphoid fracture: a review

Tan

Craigen

Porter

2009

Trauma

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The scaphoid is by far the most commonly fractured carpal bone. Occult fractures, imperceptible on initial radiographs and a reputation for non-union make diagnosis and management challenging. The past few years have seen significant advances in the assessment and surgical treatment of scaphoid fractures. This article reviews the published literature relating to acute scaphoid fractures and examines the advances that have been made in management.

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“…26 However, Groves and his team have demonstrated in a number of cases the inability of CT to identify a scaphoid fracture which was captured by MRI, bone scintigraphy and even radiographs. 27,28 This was attributed to the fact that CT relies upon cortical or trabecular displacement at the fracture site. It was also postulated that these discordant fractures may represent injuries such as bone bruising, which was seen on approximately one-third of all MRI scans covered in our audits.…”

Section: Discussionmentioning

confidence: 99%