Can follow-up radiography for acute scaphoid fracture still be considered a valid investigation?

Low G; Raby N Department of Diagnostic Imaging, Western Infirmary, Glasgow, UK. AIM: To determine whether follow-up radiography is a valid diagnostic investigation in patients with suspected acute scaphoid fractures and normal initial radiographs. MATERIALS AND METHODS: Fifty sets of radiographs (initial and follow-up) were independently assessed by four expert observers for the presence or absence of a scaphoid fracture. Magnetic resonance imaging (MRI), performed in all cases, was used as the gold standard to determine the sensitivity, specificity, positive and negative predictive values of the observers' assessment of the follow-up radiograph. In addition, the reliability among observers of the follow-up radiograph was determined by reliability variance analysis. RESULTS: Of the 50 sets of radiographs, 35 patients had a scaphoid fracture and 15 were normal, as established from MRI report. For individual observer's assessment of the follow-up radiograph, sensitivities of 11, 9, 43 ...  more