title: Added value of interpreter experience in occult and suspect hip fractures: a retrospective analysis of 254 patients.
abstract: The influence of experience in categorizing suspect and occult fractures on radiography compared to MRI and clinical outcome has not been studied. The aim of this study is to evaluate the importance of experience in diagnosing normal or suspect hip radiographs compared to MRI. Primarily reported normal or suspect radiography in 254 patients with low-energy hip trauma and subsequent MRI was re-evaluated by two experienced reviewers. Primary readings and review were compared. The prevalence of fractures among normal and suspect radiographic studies was assessed. Clinical outcome was used as reference. At review of radiography, 44 fractures (17 %) were found. Significantly more fractures were found among suspect cases than among normal cases. At MRI, all 44 fractures were confirmed, and further 64 fractures were detected (25 %). MRI detected all fractures with no missed fractures revealed at follow-up. There were a significantly higher proportion of fractures at MRI among the suspect radiographic diagnoses for both the primary report and at review than among occult cases. The more experienced reviewers classified radiography examinations with higher accuracy than primary reporting general radiologists. There was almost complete agreement on MRI diagnoses.
authors.affiliation: Department of Radiology, Sahlgrenska University Hospital, S-431 80, Mölndal, Sweden. david.collin@vgregion.se.
authors.forename: David
authors.initials: D
authors.lastname: Collin
authors.affiliation: Department of Radiology, Sahlgrenska University Hospital, S-431 80, Mölndal, Sweden.
authors.forename: Jan H
authors.initials: JH
authors.lastname: Göthlin
authors.affiliation: Department of Radiology, Sahlgrenska University Hospital, S-431 80, Mölndal, Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Nilsson
authors.affiliation: Department of Radiology, Sahlgrenska University Hospital, S-413 45, Gothenburg, Sweden.
authors.forename: Mikael
authors.initials: M
authors.lastname: Hellström
authors.affiliation: Department of Medical Imaging and Physiology, Skåne University Hospital, S-221 00, Lund, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Geijer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005188:False Negative Reactions; D005260:Female; D005596:Fractures, Closed / Q000000981:diagnostic imaging*; D006620:Hip Fractures / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies
keywords: Fracture; Hip; Magnetic resonance imaging; Occult; Proximal femur; Radiography