Panoramic versus conventional radiography of scaphoid fractures.
OBJECTIVE
The objective of this study was to compare the diagnostic value of panoramic and conventional radiography in the detection of fractures of the carpal scaphoid bone.


METHODS
Panoramic (orthopantomographic) and conventional radiographs of 90 patients with acute or chronic wrist trauma were reviewed retrospectively. Images were analyzed and reviewed independently by four observers: two radiologists and two traumatologists. The kappa statistic was used to calculate intraand interobserver agreement and the correlation between the two imaging techniques.


RESULTS
Panoramic radiography of the wrist was superior to conventional radiography in ruling out scaphoid fractures (74%, 20/27) in patients with suspicious findings on conventional radiography; revealed more cases of scaphoid fractures (21.4%, 12/56); and revealed more cases of delayed union (n = 2), nonunion (n = 3), and union (n = 3). Agreement values were higher, with better inter- and intraobserver agreement, for the panoramic examinations than for the conventional radiographic examinations.


CONCLUSIONS
The panoramic examination of the wrist is a useful technique for the diagnosis and follow-up of scaphoid fractures. Its use is recommended as a complement to conventional radiography in cases with inconclusive findings.
Berná
Juan D
JD
Department of Radiology, University General Hospital, C.E.P. Quesada Sanz c/Dr. Quesada Sans s/n, Murcia 30005, Spain. jdberna@um.es
Chavarria
German
G
Albaladejo
Francisco
F
Meseguer
Luis
L
Pellicer
Arturo
A
Sánchez-Cañizares
Miguel A
MA
Pérez-Flores
Domingo
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging* / Q000293:injuries*; D014954:Wrist Injuries / Q000000981:diagnostic imaging*