EXPERIMENTAL EVALUATION OF SCAPHOID X-SERIES, CARPAL BOX RADIOGRAPHS,PLANAR TOMOGRAPHY, COMPUTED-TOMOGRAPHY, AND MAGNETIC-RESONANCE-IMAGING IN THE DIAGNOSIS OF SCAPHOID FRACTURE

Aim: In this study, we evaluated scaphoid X-series, Carpal Box radiogr aphs (longitudinal and transverse), planar tomography, computed tomogr aphy (CT), and magnetic resonance Imaging (MRI) in the diagnosis of sc aphoid fracture, The aim of this study was to evaluate the planar tech nique in the diagnosis of scaphoid fracture, The use of planar tomogra phy, CT, and MRI was to see whether these methods are useful in the di agnosis of scaphoid fracture when other diagnostics modalities remains negative, Methods: Twenty-eight embalmed human cadaver specimens were used, in 23 of which fractures of the scaphoid were produced mechanic ally, Scaphoid X-series, Carpal Box posterior-anterior radiographs in ulnar deviation (X-CB), Carpal Box posterior-anterior views with the h and in 15-degree supination and ulnar deviation (X-CB 15-degree) were acted in all specimens, CT in eight wrists, planar tomography in seven wrists, and MRI in five wrists, The anatomic analysis of the specimen s was used as the gold standard for comparison, Scaphoid X-series, Car pal Box radiographs, and planar tomography were judged independently a nd in a blind fashion by six observers, and CT and MRI were also judge d independently and in a blind fashion by three radiologists, The obse rvers were asked if they could recognize a scaphoid fracture, The agre ement among the six observers for the scaphoid X-series and X-CB was m easured. Results: In the 23 fractured wrists, scaphoid X-series, X-CB, X-CB 15-degree, was true positive in 12, 14, and 15 wrists, respectiv ely, whereas these methods were true negative in cadaver wrists 1, 3, and 5. CT was true positive in five of five fractured wrists and true negative in three of three negative wrists, Planar tomography was true positive in one of four fractured wrists and true negative in two of three nonfractured wrists, MRI was obtained in five wrists (one withou t a fracture), of which the fracture was recognized in only two, The h ighest agreement between observers was found in the X-CB 15-degree. Co nclusion: From the planar investigated methods, the 15-degree Carpal B ox posterior-anterior, longitudinal and transverse views were most acc urate in recognizing scaphoid fracture with also the highest agreement between the observers.