M Haubro1, C Stougaard2, T Torfing2, S Overgaard3. 1. Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology and Institute of Clinical Research, University of Southern Denmark, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. Electronic address: martinhaubro@gmail.com. 2. Musculoskeletal section, Department of Radiology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. 3. Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology and Institute of Clinical Research, University of Southern Denmark, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark.
Abstract
OBJECTIVE: To estimate sensitivity and specificity of CT and MRI examinations in patients with fractures of the proximal femur. To determine the interobserver agreement of the modalities among a senior consulting radiologist, a resident in radiology and a resident in orthopaedics surgery. MATERIALS AND METHODS: 67 patients (27 males, 40 females, mean age 80.5) seen in the emergency room with hip pain after fall, inability to stand and a primary X-ray without fracture were evaluated with both CT and MRI. The images were analysed by a senior consulting musculoskeletal radiologist, a resident in radiology and a resident in orthopaedic surgery. Sensitivity and specificity were estimated with MRI as the golden standard. Kappa value was used to assess level of agreement in both MRI and CT finding. RESULTS: 15 fractures of the proximal femur were found (7 intertrochanteric-, 3 femoral neck and 5 fractures of the greater trochanter). Two fractures were not identified by CT and four changed fracture location. Among those, three patients underwent surgery. Sensitivity of CT was 0.87; 95% CI [0.60; 0.98]. Kappa for interobserver agreement for CT were 0.46; 95% CI [0.23; 0.76] and 0.67; 95% CI [0.42; 0.90]. For MRI 0.67; 95% CI [0.43; 0.91] and 0.69; 95% CI [0.45; 0.92]. CONCLUSION: MRI was observed to have a higher diagnostic accuracy than CT in detecting occult fractures of the hip. Interobserver analysis showed high kappa values corresponding substantial agreement in both CT and MRI.
OBJECTIVE: To estimate sensitivity and specificity of CT and MRI examinations in patients with fractures of the proximal femur. To determine the interobserver agreement of the modalities among a senior consulting radiologist, a resident in radiology and a resident in orthopaedics surgery. MATERIALS AND METHODS: 67 patients (27 males, 40 females, mean age 80.5) seen in the emergency room with hip pain after fall, inability to stand and a primary X-ray without fracture were evaluated with both CT and MRI. The images were analysed by a senior consulting musculoskeletal radiologist, a resident in radiology and a resident in orthopaedic surgery. Sensitivity and specificity were estimated with MRI as the golden standard. Kappa value was used to assess level of agreement in both MRI and CT finding. RESULTS: 15 fractures of the proximal femur were found (7 intertrochanteric-, 3 femoral neck and 5 fractures of the greater trochanter). Two fractures were not identified by CT and four changed fracture location. Among those, three patients underwent surgery. Sensitivity of CT was 0.87; 95% CI [0.60; 0.98]. Kappa for interobserver agreement for CT were 0.46; 95% CI [0.23; 0.76] and 0.67; 95% CI [0.42; 0.90]. For MRI 0.67; 95% CI [0.43; 0.91] and 0.69; 95% CI [0.45; 0.92]. CONCLUSION: MRI was observed to have a higher diagnostic accuracy than CT in detecting occult fractures of the hip. Interobserver analysis showed high kappa values corresponding substantial agreement in both CT and MRI.
Authors: Mostafa Alabousi; Isabelle D Gauthier; Nicole Li; Gonçalo Mf Dos Santos; Dmitry Golev; Michael N Patlas; Abdullah Alabousi Journal: Emerg Radiol Date: 2019-06-17
Authors: Andrew B Ross; Brian Y Chan; Paul H Yi; Michael D Repplinger; David J Vanness; Kenneth S Lee Journal: Skeletal Radiol Date: 2018-06-18 Impact factor: 2.199
Authors: Jacob C Mandell; Tatiana C Rocha; Maria Alejandra Duran-Mendicuti; Nityanand P Miskin; Junzi Shi; Bharti Khurana Journal: Emerg Radiol Date: 2018-07-14
Authors: Stef Jozef Marie Smeets; Wouter Vening; Michiel Bernard Winkes; Gerrit Paulus Kuijt; Gerrit Dirk Slooter; Percival Victor van Eerten Journal: Int Orthop Date: 2018-07-17 Impact factor: 3.075