Usefulness of different imaging modalities in the assessment of scapular fractures caused by blunt trauma.
OBJECTIVE
To analyze the usefulness of chest and scapular trauma radiographs, axial computed tomography (CT), and two- and three-dimensional (2D and 3D) reconstruction CT in detecting fractures of the six anatomical regions of the scapula.


METHODS
Forty-four patients, with a median age (range) of 34 (16-60) years, with scapular fractures caused by blunt trauma were prospectively collected between January 2003 and December 2005. Their chest and scapula radiographs, and axial, 2D, and 3D CTs were reviewed blindly and independently by two observers. Each modality was compared with a gold standard to determine its diagnostic usefulness. Our gold standard was consensus reached by all authors together examining all modalities at the same time. We also compared 3D CTs reconstructed from chest and scapula axial views.


RESULTS
Axial and 3D reconstruction tomographic studies were the only useful modalities in assessing fractures in all six anatomical scapular regions. Three-dimensional CTs reconstructed from chest and scapula axial views were equally sensitive and specific.


CONCLUSIONS
CT scanning with 3D reconstructions is the most useful imaging modality to detect and define the extent of scapular injury, and this can be done as part of a chest trauma computed tomography protocol.
Tadros
A M A
AM
Departments of Orthopedics and Radiology, Faculty of Medicine and Health Sciences, Al-Ain Hospital, Al-Ain, United Arab Emirates.
Lunsjo
K
K
Czechowski
J
J
Corr
P
P
Abu-Zidan
F M
FM
D000293:Adolescent; D000328:Adult; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013902:Radiography, Thoracic / Q000379:methods; D015203:Reproducibility of Results; D012540:Scapula / Q000000981:diagnostic imaging / Q000293:injuries*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000175:diagnosis*