Modified carpal box technique in the diagnosis of suspected scaphoid fractures

• Published in: Acta radiologica (1987) Vol. 44; no. 3; p. 319
• Main Authors: Toth, F, Mester, S, Cseh, G, Bener, A, Nyarady, J, Lovasz, G
• Format: Journal Article
• Language: English
• Published: England 01-05-2003
• Subjects: Adult; Algorithms; Female; Fractures, Bone - diagnostic imaging; Humans; Male; Observer Variation; Predictive Value of Tests; Radiography - methods; Scaphoid Bone - injuries; Sensitivity and Specificity; Wrist Injuries - diagnostic imaging
• ISSN: 0284-1851
• DOI: 10.1034/j.1600-0455.2003.00064.x

To establish and test the clinical efficacy of a new diagnostic algorithm with the extensive utilization of modified carpal box radiography (mX-CB) in the detection of scaphoid fractures.
Initial and early follow-up radiographic evaluation of 146 suspected scaphoid fractures were carried out by mX-CB. Patients with unconfirmed diagnosis were referred to CT. Patients were followed for 1 year after injury. Sensitivity, specificity and interobserver agreement of reading mX-CB images were determined statistically.
No non-union or avascular necrosis was seen at 1 year after the injury. 90% of the fractures were diagnosed by mX-CB, only 6.8% of the patients needed referral to CT. Sensitivity of mX-CB at initial presentation was 81.6%. Interobserver agreement was very high among evaluators of mX-CB images.
Extensive utilization of mX-CB as primary and early follow-up investigation resulted in high initial diagnostic accuracy and low referral rate to a more expensive diagnostic modality.