title: Diagnostic significance of rib series in minor thorax trauma compared to plain chest film and computed tomography.
abstract: BACKGROUND
  Rib series (RS) are a special radiological technique to improve the visualization of the bony parts of the chest.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the diagnostic accuracy of rib series in minor thorax trauma.
  
  
  METHODS
  Retrospective study of 56 patients who received RS, 39 patients where additionally evaluated by plain chest film (PCF). All patients underwent a computed tomography (CT) of the chest. RS and PCF were re-read independently by three radiologists, the results were compared with the CT as goldstandard. Sensitivity, specificity, negative and positive predictive value were calculated. Significance in the differences of findings was determined by McNemar test, interobserver variability by Cohens kappa test.
  
  
  RESULTS
  56 patients were evaluated (34 men, 22 women, mean age =61 y.). In 22 patients one or more rib fracture could be identified by CT. In 18 of these cases (82%) the correct diagnosis was made by RS, in 16 cases (73%) the correct number of involved ribs was detected. These differences were significant (p = 0.03). Specificity was 100%, negative and positive predictive value were 85% and 100%. Kappa values for the interobserver agreement was 0.92-0.96. Sensitivity of PCF was 46% and was significantly lower (p = 0.008) compared to CT.
  
  
  CONCLUSIONS
  Rib series does not seem to be an useful examination in evaluating minor thorax trauma. CT seems to be the method of choice to detect rib fractures, but the clinical value of the radiological proof has to be discussed and investigated in larger follow up studies.
authors.affiliation: Radiology, Asklepios Medical Center, Bad Abbach, Germany ; Radiology, University Medical Center, Regensburg, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Hoffstetter
authors.affiliation: Radiology, Asklepios Medical Center, Bad Abbach, Germany ; Radiology, University Medical Center, Regensburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Dornia
authors.affiliation: Radiology, University Medical Center, Regensburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Schäfer
authors.affiliation: Radiology, University Medical Center, Regensburg, Germany.
authors.forename: Merle
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Radiology, University Medical Center, Regensburg, Germany.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Dendl
authors.affiliation: Radiology, University Medical Center, Regensburg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Stroszczynski
authors.affiliation: Radiology, University Medical Center, Regensburg, Germany.
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Schreyer
keywords: Computed tomography (CT); Conventional radiography; Minor thorax trauma; Rib series (RS)