Diagnostic accuracy of multidetector computed tomography for patients with suspected scaphoid fractures and negative radiographic examinations

The aim of this prospective study was to evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) in detecting occult scaphoid fractures. A total of 54 patients with a clinically suspected scaphoid fracture and negative initial conventional radiographs were evaluated with 64-row MDCT wrist examinations within 1 week of the trauma. The gold standard used was the diagnosis on MRI done within 1 week after MDCT. The sensitivity, specifi city, positive predictive value (PPV), and negative predictive value (NPV) of MDCT were calculated. MRI showed a total of 22 fractures in 20 of 55 (36%) wrists. Fractures included 14 scaphoid and 8 other carpal bones. MDCT showed a total of 19 fractures in 17 of 55 (30%) wrists. Two isolated scaphoid fractures and one trapezium fracture were missed on MDCT. The sensitivity, specificity, PPV, and NPV of MDCT were 86%, 100%, 100%, and 91%, respectively. MDCT offers highly accurate results, especially concerning cortical involvement, and is a useful alternative in facilities lacking MRI.