Document Detail

Early computerized tomography accurately determines the presence or absence of scaphoid and other fractures.
MedLine Citation:
PMID:  17564689     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To validate the use of early CT in predicting scaphoid fracture and other fractures in patients with suspected scaphoid fracture. METHOD: A prospective observational study of adult patients with a diagnosis of clinical scaphoid fracture presenting to a regional ED. Patients were immobilized in a scaphoid plaster and had a CT (wrist and carpals) same or next day. The gold standard used was the diagnosis on Day 10 with clinical examination and X-rays, with MRI performed in patients with persistent tenderness but normal X-rays. RESULTS: Forty-seven patients completed the study protocol from September 2004 until February 2006. For all fractures, early CT had a 96.8% negative predictive value and 100% positive predictive value (94.4% sensitive, 100% specific). No scaphoid fracture was missed by early CT. One patient had a trapezium fracture on CT, with a coexistent subtle capitate fracture only detected on MRI. CONCLUSION: Early CT scans show promise in the diagnosis of scaphoid and other fractures of the wrist and carpals. Further study is warranted to validate early CT in clinical scaphoid fracture as an alternative to other early advanced imaging, or plaster immobilization and 2 week review.
Jaycen Cruickshank; Alex Meakin; Ross Breadmore; David Mitchell; Steven Pincus; Thomas Hughes; Bronwyn Bently; Mark Harris; Austin Vo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Emergency medicine Australasia : EMA     Volume:  19     ISSN:  1742-6731     ISO Abbreviation:  Emerg Med Australas     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-13     Completed Date:  2007-09-13     Revised Date:  2007-09-17    
Medline Journal Info:
Nlm Unique ID:  101199824     Medline TA:  Emerg Med Australas     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  223-8     Citation Subset:  IM    
Emergency Department, Ballarat Health Services, Ballarat, Victoria, Australia.
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MeSH Terms
Early Diagnosis
Fractures, Bone / radiography*
Magnetic Resonance Imaging
Predictive Value of Tests
Prospective Studies
Scaphoid Bone / injuries*,  radiography*
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Erratum In:
Emerg Med Australas. 2007 Aug;19(4):387

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