{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:31:19Z","timestamp":1792499479415,"version":"4.5.0"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,16]]},"abstract":"\n Background:<\/jats:title>\n Computed tomography (CT), magnetic resonance imaging, and bone scintigraphy are second-line imaging techniques that are frequently used for the evaluation of patients with a clinically suspected scaphoid fracture. However, as a result of varying diagnostic performance results, no true reference standard exists for scaphoid fracture diagnosis. We hypothesized that the use of high-resolution peripheral quantitative CT (HR-pQCT) in patients with a clinically suspected scaphoid fracture could improve scaphoid fracture detection compared with conventional CT in the clinical setting.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n The present study included 91 consecutive patients (\u226518 years of age) who presented to the emergency department with a clinically suspected scaphoid fracture between December 2017 and October 2018. All patients were clinically reassessed within 14 days after first presentation, followed by CT and HR-pQCT. If a scaphoid fracture was present, the fracture type was determined according to the Herbert classification system and correlation between CT and HR-pQCT was estimated with use of the Kendall W statistic or coefficient of concordance (W) (the closer to 1, the higher the correlation).<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The cohort included 45 men and 46 women with a median age of 52 years (interquartile range, 29 to 67 years). HR-pQCT revealed a scaphoid fracture in 24 patients (26%), whereas CT revealed a scaphoid fracture in 15 patients (16%). Patients with a scaphoid fracture were younger and more often male. The correlation between CT and HR-pQCT was high for scaphoid fracture type according to the Herbert classification system (W = 0.793; 95% confidence interval [CI], 0.57 to 0.91; p < 0.001) and very high for scaphoid fracture location (W = 0.955; 95%, CI 0.90 to 0.98; p < 0.001).<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n In the present study, the number of patients diagnosed with a scaphoid fracture was 60% higher when using HR-pQCT as compared with CT. These findings imply that a substantial proportion of fractures\u2014in this study, more than one-third\u2014will be missed by the current application of CT scanning in patients with a clinically suspected scaphoid fracture.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Diagnostic\n Level II<\/jats:underline>\n . See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.20.00124","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T21:00:20Z","timestamp":1603918820000},"page":"2138-2145","source":"Crossref","is-referenced-by-count":14,"title":["Improved Detection of Scaphoid Fractures with High-Resolution Peripheral Quantitative CT Compared with Conventional CT"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3228-0954","authenticated-orcid":false,"given":"A.M.","family":"Daniels","sequence":"first","affiliation":[{"name":"Departments of Surgery (A.M.D. and H.M.J.J.), Radiology (S.S.), Internal Medicine (C.E.W. and J.P.v.d.B.), and Orthopedic Surgery (S.K.), VieCuri Medical Centre, Venlo, the Netherlands"},{"name":"NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4036-2017","authenticated-orcid":false,"given":"M.S.A.M.","family":"Bevers","sequence":"additional","affiliation":[{"name":"Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8985-195X","authenticated-orcid":false,"given":"S.","family":"Sassen","sequence":"additional","affiliation":[{"name":"Departments of Surgery (A.M.D. and H.M.J.J.), Radiology (S.S.), Internal Medicine (C.E.W. and J.P.v.d.B.), and Orthopedic Surgery (S.K.), VieCuri Medical Centre, Venlo, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7662-3990","authenticated-orcid":false,"given":"C.E.","family":"Wyers","sequence":"additional","affiliation":[{"name":"Departments of Surgery (A.M.D. and H.M.J.J.), Radiology (S.S.), Internal Medicine (C.E.W. and J.P.v.d.B.), and Orthopedic Surgery (S.K.), VieCuri Medical Centre, Venlo, the Netherlands"},{"name":"NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands"},{"name":"Departments of Internal Medicine (C.E.W., P.P.M.M.G., and J.P.v.d.B.) and Surgery and Trauma Surgery (P.F.W.H. and M.P.), Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2278-2934","authenticated-orcid":false,"given":"B.","family":"van Rietbergen","sequence":"additional","affiliation":[{"name":"Orthopedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands"},{"name":"Department of Orthopedic Surgery, Research School CAPHRI, Maastricht University, Maastricht, the 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