Comparison of X-Ray Imaging and Computed Tomography Scan in the Evaluation of Knee Trauma

Background and objectives: The aim of the study was to compare the accuracy of X-ray (XR) imaging according to computed tomography (CT) scanning in the diagnosis of knee bone fractures, and in the determination of fracture characteristics, and to identify CT scan indications in patients with knee tr...

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Main Authors: Mustafa Avci, Nalan Kozaci
Format: Article
Language:English
Published: MDPI AG 2019-09-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1010-660X/55/10/623
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author Mustafa Avci
Nalan Kozaci
author_facet Mustafa Avci
Nalan Kozaci
author_sort Mustafa Avci
collection DOAJ
description Background and objectives: The aim of the study was to compare the accuracy of X-ray (XR) imaging according to computed tomography (CT) scanning in the diagnosis of knee bone fractures, and in the determination of fracture characteristics, and to identify CT scan indications in patients with knee trauma. Materials and methods: The patients who presented to the emergency department (ED) due to knee trauma between January 2017 and December 2018 and who underwent XR imaging and CT scans were included in the study. XR images were reinterpreted by an emergency physician. The official reports, which had been interpreted by a radiologist in the hospital automation system for CT images, were considered valid. Results: Five hundred and forty-eight patients were included in the study. Of the patients, 200 (36.5%) had fractures in XR imaging and 208 (38.0%) had fractures in CT scans. Compared to CT scanning, XR imaging was found to have 89% sensitivity, 95% specificity, 92% positive predictive value, and 92% negative predictive value in identifying the fracture. The sensitivity of XR imaging in identifying growth plate fracture, angulation, stepping off, and extension of the fracture into the joint space was determined as 78% and less. According to the kappa value, there was determined a perfect concordance between the XR imaging and CT scans in angulation, stepping off, and extension of the fracture into the joint space. This concordance was moderate in growth plate fractures. Conclusions: XR imaging has a low sensitivity in identifying knee fractures. There is a moderate concordance between XR imaging and CT scanning in identifying growth plate fractures. Therefore, CT scanning should be performed in patients whose fracture type and fracture characteristics are not able to be determined exactly with XR imaging in knee injury.
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spelling doaj.art-bf0c74d880664ff28fd4d1035a4d7c652023-09-02T13:33:24ZengMDPI AGMedicina1010-660X2019-09-01551062310.3390/medicina55100623medicina55100623Comparison of X-Ray Imaging and Computed Tomography Scan in the Evaluation of Knee TraumaMustafa Avci0Nalan Kozaci1Department of Emergency Medicine; University of Health Sciences, Antalya Education and Research Hospital, Antalya 07100, TurkeyDepartment of Emergency Medicine; University of Health Sciences, Antalya Education and Research Hospital, Antalya 07100, TurkeyBackground and objectives: The aim of the study was to compare the accuracy of X-ray (XR) imaging according to computed tomography (CT) scanning in the diagnosis of knee bone fractures, and in the determination of fracture characteristics, and to identify CT scan indications in patients with knee trauma. Materials and methods: The patients who presented to the emergency department (ED) due to knee trauma between January 2017 and December 2018 and who underwent XR imaging and CT scans were included in the study. XR images were reinterpreted by an emergency physician. The official reports, which had been interpreted by a radiologist in the hospital automation system for CT images, were considered valid. Results: Five hundred and forty-eight patients were included in the study. Of the patients, 200 (36.5%) had fractures in XR imaging and 208 (38.0%) had fractures in CT scans. Compared to CT scanning, XR imaging was found to have 89% sensitivity, 95% specificity, 92% positive predictive value, and 92% negative predictive value in identifying the fracture. The sensitivity of XR imaging in identifying growth plate fracture, angulation, stepping off, and extension of the fracture into the joint space was determined as 78% and less. According to the kappa value, there was determined a perfect concordance between the XR imaging and CT scans in angulation, stepping off, and extension of the fracture into the joint space. This concordance was moderate in growth plate fractures. Conclusions: XR imaging has a low sensitivity in identifying knee fractures. There is a moderate concordance between XR imaging and CT scanning in identifying growth plate fractures. Therefore, CT scanning should be performed in patients whose fracture type and fracture characteristics are not able to be determined exactly with XR imaging in knee injury.https://www.mdpi.com/1010-660X/55/10/623computed tomographyemergency departmentfracture characteristicsknee injuryX-ray
spellingShingle Mustafa Avci
Nalan Kozaci
Comparison of X-Ray Imaging and Computed Tomography Scan in the Evaluation of Knee Trauma
Medicina
computed tomography
emergency department
fracture characteristics
knee injury
X-ray
title Comparison of X-Ray Imaging and Computed Tomography Scan in the Evaluation of Knee Trauma
title_full Comparison of X-Ray Imaging and Computed Tomography Scan in the Evaluation of Knee Trauma
title_fullStr Comparison of X-Ray Imaging and Computed Tomography Scan in the Evaluation of Knee Trauma
title_full_unstemmed Comparison of X-Ray Imaging and Computed Tomography Scan in the Evaluation of Knee Trauma
title_short Comparison of X-Ray Imaging and Computed Tomography Scan in the Evaluation of Knee Trauma
title_sort comparison of x ray imaging and computed tomography scan in the evaluation of knee trauma
topic computed tomography
emergency department
fracture characteristics
knee injury
X-ray
url https://www.mdpi.com/1010-660X/55/10/623
work_keys_str_mv AT mustafaavci comparisonofxrayimagingandcomputedtomographyscanintheevaluationofkneetrauma
AT nalankozaci comparisonofxrayimagingandcomputedtomographyscanintheevaluationofkneetrauma