MRI diagnosis of fracture of the scaphoid bone: Impact of a new practice where the images are read by radiographers
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MRI diagnosis of fracture of the scaphoid bone : Impact of a new practice where the images are read by radiographers. / Møller, Jakob M.; Larsen, Lone; Bovin, Jan; Lausten, Gunnar S.; Hasselqvist, Maria; Jensen, Claus Munk; Ropke, Ian; Thomsen, Henrik S.
In: Academic Radiology, Vol. 11, No. 7, 01.07.2004, p. 724-728.Research output: Contribution to journal › Journal article › Research › peer-review
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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 -
ID: 222709421