Evaluating the potential for cone beam CT to improve the suspected scaphoid fracture pathway: InSPECTED: A single-centre feasibility study
| Autor: | Gareth Bessant, Beverly Snaith, Ayano Tachibana, Bethany Shinkins, Martine A. Harris, Nicholas Spencer, James Hughes, Sarah Robertshaw |
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| Rok vydání: | 2022 |
| Předmět: |
Scaphoid Bone
Cone beam computed tomography medicine.medical_specialty Rehabilitation Radiological and Ultrasound Technology business.industry medicine.medical_treatment Gold standard Scaphoid fracture Cone-Beam Computed Tomography Wrist Wrist Injuries medicine.disease Fractures Bone Carpal bones Single centre medicine.anatomical_structure Feasibility Studies Humans Medicine Radiology Nuclear Medicine and imaging Radiology business Cone beam ct |
| Zdroj: | Journal of Medical Imaging and Radiation Sciences. 53:35-40 |
| ISSN: | 1939-8654 |
| DOI: | 10.1016/j.jmir.2021.10.002 |
| Popis: | Background The suspected scaphoid fracture remains a diagnostic conundrum with over-treatment a common risk-averse strategy. Cross-sectional imaging remains the gold standard with MRI recommended but CT used by some because of easier access or limited MRI availability. The aim of this feasibility study was to evaluate whether cone beam computed tomography (CBCT) could support early diagnosis, or exclusion, of scaphoid fractures. Methods Patients with a suspected scaphoid were recruited fracture between March and July 2020. All underwent a 4-view X-ray. If this examination was normal, they were immediately referred for a CBCT scan of the wrist. Those with a normal scan were discharged to research follow-up at 2 and 6-weeks. Results 68 participants were recruited, 55 had a normal or equivocal X-ray and underwent CBCT. Nine additional radiocarpal fractures (16.2%) were demonstrated on CBCT, the remainder were discharged to research follow-up. Based on the 2-week and 6-week follow up three patients (4.4%) were referred for MRI to investigate persistent symptoms with no bony injuries identified. Conclusions CBCT scans enabled a rapid pathway for the diagnosis or exclusion of scaphoid fractures, identifying other fractures and facilitating early treatment. The rapid pathway also enabled those with no bony injury to start rehabilitation, suggesting that patients can be safely discharged with safety-net advice following a CBCT scan. |
| Databáze: | OpenAIRE |
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