title: Comparison of conventional radiography and MDCT in suspected scaphoid fractures.
abstract: OBJECTIVE
  To determine the diagnostic accuracy and radiation dose of conventional radiography and multidetector computed tomography (MDCT) in suspected scaphoid fractures.
  
  
  METHODS
  One hundred twenty-four consecutive patients were enrolled in our study who had suffered from a wrist trauma and showed typical clinical symptoms suspicious of an acute scaphoid fracture. All patients had initially undergone conventional radiography. Subsequent MDCT was performed within 10 d because of persisting clinical symptoms. Using the MDCT data as the reference standard, a fourfold table was used to classify the test results. The effective dose and impaired energy were assessed in order to compare the radiation burden of the two techniques. The Wilcoxon test was performed to compare the two diagnostic modalities.
  
  
  RESULTS
  Conventional radiography showed 34 acute fractures of the scaphoid in 124 patients (42.2%). Subsequent MDCT revealed a total of 42 scaphoid fractures. The sensitivity of conventional radiography for scaphoid fracture detection was 42.8% and its specificity was 80% resulting in an overall accuracy of 59.6%. Conventional radiography was significantly inferior to MDCT (P < 0.01) concerning scaphoid fracture detection. The mean effective dose of MDCT was 0.1 mSv compared to 0.002 mSv of conventional radiography.
  
  
  CONCLUSIONS
  Conventional radiography is insufficient for accurate scaphoid fracture detection. Regarding the almost negligible effective dose, MDCT should serve as the first imaging modality in wrist trauma.
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Cyrus
authors: C
authors: Behzadi
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Murat
authors: M
authors: Karul
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Frank Oliver
authors: FO
authors: Henes
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Azien
authors: A
authors: Laqmani
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Philipp
authors: P
authors: Catala-Lehnen
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Wolfgang
authors: W
authors: Lehmann
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Hans-Dieter
authors: HD
authors: Nagel
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Gerhard
authors: G
authors: Adam
authors: Cyrus Behzadi, Murat Karul, Frank Oliver Henes, Azien Laqmani, Gerhard Adam, Marc Regier, Center for Radiology and Endoscopy, Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
authors: Marc
authors: M
authors: Regier
keywords: Biplane radiography; Diagnostic accuracy; Dose calculation; Emergency radiology; Multidetector computed tomography; Musculoskeletal imaging; Scaphoid fracture; Wrist trauma
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