Purpose: To determine the interobserver variability among radiologists for computed tomography (CT) diagnosis of scaphoid fractures.
Methods: Four specialized musculoskeletal radiologists evaluated the CT scans of 150 consecutive patients who were clinically suspected of having sustained a scaphoid fracture but whose scaphoid-specific radiographs were normal. The radiologists were asked to determine the presence or absence of a scaphoid fracture and to localize the fracture. Interobserver agreement was calculated using the kappa statistic.
Results: The radiologists diagnosed between 11 (7%) and 22 (15%) scaphoid fractures; the kappa value was 0.51.
Conclusion: Agreement on the presence of a scaphoid fracture and its location on a CT scan was moderate among the 4 radiologists. This finding raises the question as to whether scaphoid fractures could be under- or overdiagnosed in daily practice when CT is used to exclude or confirm a fracture. This should be kept in mind when interpreting clinical and radiological results in patients with suspected scaphoid fractures.
Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.