Abstract
BackgroundRib series (RS) are a special radiological technique to improve the visualization of the bony parts of the chest.ObjectivesThe aim of this study was to evaluate the diagnostic accuracy of rib series in minor thorax trauma.MethodsRetrospective study of 56 patients who received RS, 39 patients where additionally evaluated by plain chest film (PCF). All patients underwent a computed tomography (CT) of the chest. RS and PCF were re-read independently by three radiologists, the results were compared with the CT as goldstandard. Sensitivity, specificity, negative and positive predictive value were calculated. Significance in the differences of findings was determined by McNemar test, interobserver variability by Cohens kappa test.Results56 patients were evaluated (34 men, 22 women, mean age =61 y.). In 22 patients one or more rib fracture could be identified by CT. In 18 of these cases (82%) the correct diagnosis was made by RS, in 16 cases (73%) the correct number of involved ribs was detected. These differences were significant (p = 0.03). Specificity was 100%, negative and positive predictive value were 85% and 100%. Kappa values for the interobserver agreement was 0.92-0.96. Sensitivity of PCF was 46% and was significantly lower (p = 0.008) compared to CT.ConclusionsRib series does not seem to be an useful examination in evaluating minor thorax trauma. CT seems to be the method of choice to detect rib fractures, but the clinical value of the radiological proof has to be discussed and investigated in larger follow up studies.
Highlights
Conventional rib series (RS), called oblique views, are a very common routinely performed radiological examination in any radiological department
Rib series does not seem to be an useful examination in evaluating minor thorax trauma
computed tomography (CT) seems to be the method of choice to detect rib fractures, but the clinical value of the radiological proof has to be discussed and investigated in larger follow up studies
Summary
Conventional rib series (RS), called oblique views, are a very common routinely performed radiological examination in any radiological department. It represents a special radiographic technique to visualize the bony parts of the chest wall by one or more oblique views, with or without marking the points of maximum tenderness. Comparing with plain chest films the examinations are acquired with lower x-ray energy and a smaller field of view to optimize the bony contrast of the ribs. RS are very often combined with plain chest films (PCF), to rule out pneumo- or hematothorax. Both diagnostic strategies are being used, the initial combination of RS with PCF or the consecutive combination. Rib series (RS) are a special radiological technique to improve the visualization of the bony parts of the chest
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