Does radiography still have a significant diagnostic role in evaluation of acute traumatic wrist injuries? A prospective comparative study.

Abstract

The aim of this study was to evaluate and compare the diagnostic role of radiography and multi-detector computed tomography (MDCT) in acute traumatic wrist injuries. One hundred sixty-eight patients with acute wrist trauma were enrolled in our study. All patients had submitted to radiography and MDCT within 24h after wrist trauma. The diagnostic role of radiography and MDCT was evaluated and compared. The effective radiation dose of the two techniques was calculated. One hundred four (61.9%) and 84 (50%) out of 168 patients had acute wrist injuries on MDCT and radiographic examinations, respectively. Using MDCT results as a reference standard, the sensitivity, specificity, and accuracy of radiography in the diagnosis of distal radius fracture were 85.7, 96, and 92.3%, respectively, and in the diagnosis of scaphoid fracture were 62.5, 97.3, and 88.5%, respectively. As regards detection of acute traumatic wrist injuries, we observed no significant difference between the two modalities (P=0.1347); in addition, both modalities had high consistency (κ=0.8359). The mean effective radiation dose of radiography was 0.01 mSv and of MDCT was 0.1 mSv. Radiography still remains as the first screening tool in acute traumatic wrist injuries and MDCT is complementary to it and used as a problem-solving tool or for preoperative planning.