ACUTE KNEE TRAUMA - HOW MANY PLAIN FILM VIEWS ARE NECESSARY FOR THE INITIAL EXAMINATION

Objective, To determine whether anteroposterior (AP) and lateral views of the knee are equivalent to four views in acute fracture detection. Design. Three musculoskeletal radiologists retrospectively interprete d the plain film knee examinations of each patient, establishing groun d truth for the presence or absence of a fracture, Cases were presente d to four masked senior radiology residents twice - once as a two-view study and again as a four-view study - with 4 weeks separating the tw o reading sessions to minimize recall bias, Sensitivity, specificity, and diagnostic performance were calculated, Patients. Ninety-two patie nts presenting to the emergency department with acute knee trauma. wer e evaluated with at least a four-view plain film examination. Results and conclusions. Mean sensitivity for fracture detection using four vi ews (85%) was significantly higher than that using two views (79%), Me an specificity and receiver operating characteristic curve areas were not significantly different using two or four views, Four views are mo re sensitive than AP and lateral views alone in detection of acute kne e fracture.