Personal tools
Log in
Sections

Skip to content. | Skip to navigation

Document Actions
Home › Publications › Readers' Pages

Readers' Pages

« Back to All Articles

The clinical scaphoid fracture: early computed tomography as a practical approach

Ann R Coll Surg Engl 2008; 90: 488-91


Read the original article

Add a response

Response to: The clinical scaphoid fracture: early computed tomography as a practical approach

Jaffer U, Alyas F
Ipswich Hospital

20 Mar 09

We read with interest the paper by Nguyen et al. reporting a series from 2001 to 2003 on CT-imaging clinically suspected scaphoid fractures.



We have two concerns regarding the conclusions of this study. First, we suggest that the findings of this historic study may have been superseded in the era of multi-detector computerised tomography. Second, we would be interested to know what the false negative rate was for CT in this study and how this might have been established.



We suggest that limited sequence acquisition with magnetic resonance (Coronal T1 and STIR) would have had a lower false negative rate and greater positive and negative predictive power, without exposure to ionising radiation - particularly important in dealing with a potentially disabling pathology in young people.1 This has been shown to be a cost-effective strategy.2-3




References

1. Memarsadeghi M, Breitenseher MJ, Schaefer-Prokop C et al. Occult scaphoid fractures: comparison of multidetector CT and MR imaging--initial experience. Radiology 2006; 240: 169-76.

2. Brydie A, Raby N. Early MRI in the management of clinical scaphoid fracture. Br J Radiol 2003; 76: 296-300.

3. Dorsay TA, Major NM, Helms CA. Cost-effectiveness of immediate MRI imaging versus traditional follow-up for revealing radiographically occult scaphoid fractures. AJR Am J Roentgenol 2001; 177: 1,257-63.