Role of Multi-Detector CT in Evaluation of Carpal Bone Fracture in Wrist Injuries

Abstract

Multi-detector computed tomography imaging (MDCT) has become a standard imaging modality for the evaluation of patients with carpal bone fractures. Major advantages of MDCT are faster scanning time, increased volume coverage, and improved spatial and temporal resolution. These advantages also result in an increased number of slices obtained within a certain amount of time, which depends on the number of rows or channels. Aim of study: to evaluate the role of MDCT in assessment of carpal bones fractures in wrist injuries. Subjects and methods: The study was carried out in Radiology department of Benha university hospital, where 57 symptomatic patients with clinical suspicious of carpal bone fracture suffering from wrist joint disorders like pain, swelling and limitation of movement. Results: X-ray was able to detect fractures in 37 cases (64.9%), while 20 cases (35.1%) appeared negative from fractures. CT was able to detect fractures in 50 cases (87.7%) of cases, while only 7 cases (12.3%) were negative from fractures. There was a significant agreement between the two diagnostic techniques in all bony fractures, apart from lunate, pisiform, and distal ulnar fractures. CT was highly sensitive more than X-ray in these 3 fractures Conclusion: Radiography remains the primary imaging modality in wrist trauma, but in cases where there is doubt; MDCT can be used to rule out fractures. It also detects occult fractures and shows the exact fracture anatomy in wrist fractures, increasing diagnostic accuracy and eventually helping the attending physician.