The value of radiographs and bone scintigraphy in suspected scaphoid fracture. A statistical analysis

J Hand Surg Br. 1993 Jun;18(3):403-6. doi: 10.1016/0266-7681(93)90074-p.

Abstract

The role of radiography and bone scintigraphy in the diagnostic management of suspected scaphoid fracture is controversial. Two strategies were compared for patients with initial negative radiographs: repeated radiography versus selective bone scintigraphy. Using the known positive predictive value of scintigraphy, the sensitivity and specificity of both diagnostic strategies were evaluated in a series of 78 consecutive patients. The kappa value for initial radiographs was 0.76 but decreased to 0.5 for follow-up radiographs. Similarly, sensitivity decreased from 64% to 30% in follow-up radiographs. Specificity of the bone scan was 98%. The best diagnostic strategy in the management of clinically suspected scaphoid fractures consists of initial radiography followed by bone scintigraphy in patients with negative radiographs.

MeSH terms

  • Adult
  • Aged
  • Carpal Bones / diagnostic imaging
  • Carpal Bones / injuries*
  • Female
  • Fractures, Closed / diagnosis*
  • Fractures, Closed / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Observer Variation
  • Predictive Value of Tests
  • Prospective Studies
  • Radiography / statistics & numerical data
  • Radionuclide Imaging / statistics & numerical data
  • Sensitivity and Specificity