The Accuracy of Pain Measurement in Diagnosis of Scaphoid Bone Fractures in Patients with Magnetic Resonance Imaging: Report of 175 Cases.
BACKGROUND
Scaphoid fracture is the most common fracture among the bones of the wrist. Plain radiography has a sensitivity of 59 to 79 percent for the diagnosis of scaphoid fracture after injury. Casting is done to avoid complications in patients with suspected fractures with normal radiography. Magnetic resonance imaging (MRI) has a sensitivity of 100% and a specificity of 99%. To avoid unnecessary casting and high costs, we decided to offer a way more efficient than radiography and less costly than MRI.


METHODS
In the present study, 175 patients with suspected scaphoid fracture along with snuff box tenderness and normal radiography were enrolled in the study. On arrival, patients' pain score were determined using visual analog scale method with anatomical snuffbox tenderness and then MRI was performed on the patients' wrist and the results were recorded for patient in the check list. The data was then aggregated and analyzed.


RESULTS
The result of MRI for fracture was negative for 90.9% and positive for 9.1%. The mean pain score was 7.3 in negative MRI group and 8.75 in positive MRI group, considering a significant difference. ROC curve graph showed that the sensitivity and specificity will be 87% and 57%, respectively for scores 7.5 and higher and 75% and 72%, respectively for scores 8.5 and higher.


CONCLUSIONS
It seems that although this method, beside other criteria in the diagnosis of fractures, can be useful in future studies, it would not be helpful in fracture detection.
Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohammad Davood
MD
Sharifi
Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Hamid Zamani
HZ
Moghaddam
Department of Emergency Medicine, Hasheminejad Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Hosein
H
Zakeri
Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Mohsen
M
Ebrahimi
Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran.
Hesamoddin
H
Saeedian
Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Amir Masoud
AM
Hashemian
D000328:Adult; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015203:Reproducibility of Results; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries*; D012680:Sensitivity and Specificity; D055815:Young Adult
Diagnosis; MRI; Pain measurement; Scaphoid bone fractures; Surgery