THE VALUE OF RADIOGRAPHS AND BONE-SCINTIGRAPHY IN SUSPECTED SCAPHOID FRACTURE - A STATISTICAL-ANALYSIS

The role of radiography and bone scintigraphy in the diagnostic manage ment of suspected scaphoid fracture is controversial. Two strategies w ere compared for patients with initial negative radiographs: repeated radiography versus selective bone scintigraphy. Using the known positi ve predictive value of scintigraphy, the sensitivity and specificity o f both diagnostic strategies were evaluated in a series of 78 consecut ive patients. The kappa value for initial radiographs was 0.76 but dec reased to 0.5 for follow-up radiographs. Similarly, sensitivity decrea sed from 64% to 30% in follow-up radiographs. Specificity of the bone scan was 98%. The best diagnostic strategy in the management of clinic ally suspected scaphoid fractures consists of initial radiography foll owed by bone scintigraphy in patients with negative radiographs.