Does radiography still have a significant diagnostic role in evaluation of acute traumatic wrist injuries? A prospective comparative study.

AIM: The aim of this study was to evaluate and compare the diagnostic role of radiography and multi-detector computed tomography (MDCT) in acute traumatic wrist injuries.

PATIENTS AND METHODS: One hundred sixty-eight patients with acute wrist trauma were enrolled in our study. All patients had submitted to radiography and MDCT within 24 h after wrist trauma. The diagnostic role of radiography and MDCT was evaluated and compared. The effective radiation dose of the two techniques was calculated.

RESULTS: One hundred four (61.9%) and 84 (50%) out of 168 patients had acute wrist injuries on MDCT and radiographic examinations, respectively. Using MDCT results as a reference standard, the sensitivity, specificity, and accuracy of radiography in the diagnosis of distal radius fracture were 85.7, 96, and 92.3%, respectively, and in the diagnosis of scaphoid fracture were 62.5, 97.3, and 88.5%, respectively. As regards detection of acute traumatic wrist injuries, we observed no significant difference between the two modalities (P = 0.1347); in addition, both modalities had high consistency (κ = 0.8359). The mean effective radiation dose of radiography was 0.01 mSv and of MDCT was 0.1 mSv.

CONCLUSION: Radiography still remains as the first screening tool in acute traumatic wrist injuries and MDCT is complementary to it and used as a problem-solving tool or for preoperative planning.