TY - JOUR

T1 - MRI diagnosis of fracture of the scaphoid bone

T2 - Impact of a new practice where the images are read by radiographers

AU - Møller, Jakob M.

AU - Larsen, Lone

AU - Bovin, Jan

AU - Lausten, Gunnar S.

AU - Hasselqvist, Maria

AU - Jensen, Claus Munk

AU - Ropke, Ian

AU - Thomsen, Henrik S.

PY - 2004/7/1

Y1 - 2004/7/1

N2 - Rationale and objectives To investigate whether magnetic resonance imaging (MRI) radiographers are able to evaluate MRI examinations with regard to scaphoid fractures to save patients unnecessary immobilization and clinical and radiographic examinations, and to reduce the costs for the hospital as well as society in general. Materials and methods Over a 1-year period 224 consecutive patients with a suspected clinical scaphoid fracture but negative radiography were referred for MRI and examined within 11 hours. The MR images were primarily evaluated by the MRI radiographer on duty. Other fractures and bone edema were not reported because these were not part of the work-up protocol agreed upon by the radiology and the orthopedic departments. The following weekday a final report was provided by a radiologist. For the economical analysis the official price-list for Danish hospital service was used. Results The MRI radiographers reported 43 scaphoid fractures, whereas the radiologist ultimately diagnosed only 36 scaphoid fractures (16.1% of patients) (sensitivity, 100%; specificity, 96.3%). Six of the seven false-positive fractures occurred in patients with edema of the scaphoid. The seventh false-positive was a fracture of the capitate. The hospital saved at least €20,000 and the social care system €70.000. Conclusion It is possible to provide an acute MRI service to patients with clinically suspected fracture of the scaphoid and a normal plain radiograph. The MR images can be primarily read by sufficiently trained MR radiographers. This new work-up protocol reduces the cost for society.

AB - Rationale and objectives To investigate whether magnetic resonance imaging (MRI) radiographers are able to evaluate MRI examinations with regard to scaphoid fractures to save patients unnecessary immobilization and clinical and radiographic examinations, and to reduce the costs for the hospital as well as society in general. Materials and methods Over a 1-year period 224 consecutive patients with a suspected clinical scaphoid fracture but negative radiography were referred for MRI and examined within 11 hours. The MR images were primarily evaluated by the MRI radiographer on duty. Other fractures and bone edema were not reported because these were not part of the work-up protocol agreed upon by the radiology and the orthopedic departments. The following weekday a final report was provided by a radiologist. For the economical analysis the official price-list for Danish hospital service was used. Results The MRI radiographers reported 43 scaphoid fractures, whereas the radiologist ultimately diagnosed only 36 scaphoid fractures (16.1% of patients) (sensitivity, 100%; specificity, 96.3%). Six of the seven false-positive fractures occurred in patients with edema of the scaphoid. The seventh false-positive was a fracture of the capitate. The hospital saved at least €20,000 and the social care system €70.000. Conclusion It is possible to provide an acute MRI service to patients with clinically suspected fracture of the scaphoid and a normal plain radiograph. The MR images can be primarily read by sufficiently trained MR radiographers. This new work-up protocol reduces the cost for society.

KW - acute work-up

KW - Magnetic resonance imaging (MRI)

KW - radiographic reporting

KW - scaphoid facture

UR - http://www.scopus.com/inward/record.url?scp=3042799908&partnerID=8YFLogxK

U2 - 10.1016/j.acra.2004.03.049

DO - 10.1016/j.acra.2004.03.049

M3 - Journal article

C2 - 15217588

AN - SCOPUS:3042799908

VL - 11

SP - 724

EP - 728

JO - Academic Radiology

JF - Academic Radiology

SN - 1076-6332

IS - 7

ER -