Validity of bone scans to detect missed injury in patients with major trauma

Ulus Travma Acil Cerrahi Derg. 2019 Mar;25(2):183-187. doi: 10.5505/tjtes.2018.55068.

Abstract

Background: It is easy to miss injuries in patients with major trauma (MT). The authors hypothesized that bone scans (BSs) would reduce the number of missed injuries. However, there was not enough evidence on BS in patients with MT. The purpose of the present study was to identify the basic results of BS in patients with MT.

Methods: The medical records of patients with MT between January 2013 and December 2013 were reviewed. Patients who underwent a BS were enrolled in the study. Hot-uptake lesions without previous evaluation were checked by X-ray. Hot-uptake lesions on BSs that differed from previous evaluations were checked by computed tomography (CT) scans. The results of BSs were analyzed along with the results of X-ray and CT scans. The sensitivity, specificity, positive predictive value, and negative predictive value (NPV) were calculated.

Results: There were 115 patients with MT who received BS during the study period. The sensitivities were high on average (98.48-86.54). In addition, the NPVs were high (96.30-82.93). There were 16 cases of hidden fracture diagnosed after a BS.

Conclusion: BS showed high sensitivity and high NPV. Further large-scale studies might add more validity to the use of BS in patients with MT.

MeSH terms

  • Delayed Diagnosis / prevention & control
  • Fractures, Bone / diagnostic imaging*
  • Humans
  • Radiography / statistics & numerical data*
  • Retrospective Studies
  • Tomography, X-Ray Computed / statistics & numerical data*
  • Wounds and Injuries / diagnostic imaging*