title: Diagnostic accuracy of multidetector computed tomography for patients with suspected scaphoid fractures and negative radiographic examinations.
abstract: OBJECTIVE
  The aim of this prospective study was to evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) in detecting occult scaphoid fractures.
  
  
  METHODS
  A total of 54 patients with a clinically suspected scaphoid fracture and negative initial conventional radiographs were evaluated with 64-row MDCT wrist examinations within 1 week of the trauma. The gold standard used was the diagnosis on MRI done within 1 week after MDCT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT were calculated.
  
  
  RESULTS
  MRI showed a total of 22 fractures in 20 of 55 (36%) wrists. Fractures included 14 scaphoid and 8 other carpal bones. MDCT showed a total of 19 fractures in 17 of 55 (30%) wrists. Two isolated scaphoid fractures and one trapezium fracture were missed on MDCT. The sensitivity, specificity, PPV, and NPV of MDCT were 86%, 100%, 100%, and 91%, respectively.
  
  
  CONCLUSIONS
  MDCT offers highly accurate results, especially concerning cortical involvement, and is a useful alternative in facilities lacking MRI.
authors.affiliation: Department of Radiology, Gulhane Military Medical Academy, Ankara, Turkey.
authors.forename: Ahmet Turan
authors.initials: AT
authors.lastname: Ilica
authors.forename: Selahattin
authors.initials: S
authors.lastname: Ozyurek
authors.forename: Ozkan
authors.initials: O
authors.lastname: Kose
authors.forename: Murat
authors.initials: M
authors.lastname: Durusu
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging* / Q000293:injuries*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D051223:Trapezoid Bone / Q000000981:diagnostic imaging / Q000293:injuries