Reliability of bone scintigraphy for suspected scaphoid fractures.
OBJECTIVE
To examine the observer variation for bone scintigraphy in the detection of occult scaphoid fractures in daily practice, using only the early bone scanning images.


METHODS
One hundred bone scans of patients with a suspected scaphoid fracture but negative initial radiographs were prospectively included to calculate the inter- and intraobserver variation. Three nuclear medicine physicians independently evaluated all bone scans at 2 different points in time with a 3-month interval. The observers filled out a blinded scoring sheet for each patient. They scored if a scaphoid fracture was present or not. In addition, they scored the presence or absence of another fracture. The inter- and intraobserver variation was analyzed using the kappa statistic.


RESULTS
The interobserver variation showed substantial agreement for a scaphoid fracture and almost perfect agreement for another fracture. The intraobserver variation showed almost perfect agreement for both a scaphoid fracture and another fracture.


CONCLUSIONS
In the present study, early static images of bone scintigraphy for suspected scaphoid fractures showed very little inter- and intraobserver variation. In addition, expertise does not seem to have a negative influence on the results. This enhances the possibility of using bone scintigraphy in daily practice.
Beeres
Frank J P
FJ
Department of Surgery, Medical Centre Haaglanden, The Hague, The Netherlands. f.j.p.beeres@lumc.nl
Hogervorst
Mike
M
Rhemrev
Steven J
SJ
Le Cessie
Saskia
S
Arndt
Jan Willem
JW
Stokkel
Marcel P M
MP
Bartlema
Kees A
KA
Hamming
Jaap F
JF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015588:Observer Variation; D011877:Radionuclide Imaging; D011885:Radius Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology; D015203:Reproducibility of Results; D021361:Scaphoid Bone / Q000000981:diagnostic imaging* / Q000293:injuries*