Evaluating the potential for cone beam CT to improve the suspected scaphoid fracture pathway: InSPECTED: A single-centre feasibility study.

SNAITH, Beverly, HARRIS, Martine, HUGHES, James, SPENCER, Nicholas, SHINKINS, Bethany, TACHIBANA, Ayano, BESSANT, Gareth and ROBERTSHAW, Sarah (2022). Evaluating the potential for cone beam CT to improve the suspected scaphoid fracture pathway: InSPECTED: A single-centre feasibility study. Journal of medical imaging and radiation sciences, 53 (1), 35-40.

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Abstract

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.

Item Type:	Article
Uncontrolled Keywords:	Scaphoid Bone; Humans; Wrist Injuries; Feasibility Studies; Fractures, Bone; Cone-Beam Computed Tomography; Scaphoid; Carpal bones; Fractures; Cone-beam computed tomography; X-ray; Carpal bones; Cone-beam computed tomography; Fractures; Scaphoid; X-ray; Cone-Beam Computed Tomography; Feasibility Studies; Fractures, Bone; Humans; Scaphoid Bone; Wrist Injuries; 0903 Biomedical Engineering; 1103 Clinical Sciences; 1112 Oncology and Carcinogenesis
Identification Number:	https://doi.org/10.1016/j.jmir.2021.10.002
Page Range:	35-40
SWORD Depositor:	Symplectic Elements
Depositing User:	Symplectic Elements
Date Deposited:	25 Nov 2022 17:44
Last Modified:	12 Oct 2023 09:01
URI:	https://shura.shu.ac.uk/id/eprint/31072

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