Use of DTS in Suspected Acute Scaphoid Fractures in Adults.
Research type
Research Study
Full title
Use of Digital Tomosynthesis in Suspected Acute Scaphoid Fractures in Adults; a Diagnostic Accuracy Study.
IRAS ID
323490
Contact name
Helen Hopkins
Contact email
Sponsor organisation
Birmingham City University
Duration of Study in the UK
0 years, 1 months, 31 days
Research summary
This study aims to assess and evaluate the routine use of Digital Tomosynthesis (DTS) in diagnosing scaphoid fractures in adults (aged 18-65 Years) who present to Accident and Emergency Department (A&E) or Urgent Treatment Centre (UTC) with acute wrist injury and suspected scaphoid fracture.
Scaphoid fractures are the most common of the carpal fractures resulting generally from a fall onto an outstretched hand. They can be difficult to diagnose especially on initial presentation. Currently MRI imaging is recognized as the gold standard in diagnosing scaphoid fractures, however MRI is not readily available with long wait times. Current widely accepted practice involves initial plain film imaging and then repeat plain film imaging in 10-14 days if there is continued clinical suspicion. If after this time there is still suspicion of a fracture then MRI or even CT is undertaken.
Failure to diagnose scaphoid fractures can have long term detrimental effects to wrist function for the patient.
DTS can be undertaken on initial presentation alongside the plain film images within the General X-ray room. DTS uses ionising radiation in the form of X-rays. The resultant images allow for slices to be reconstructed within the plane the patient was imaged. This allows for greater detail and visualization of the imaged anatomy. Potentially this can help in earlier diagnosis of scaphoid fracture and reduce the need of follow up examinations, alternative imaging and multiple clinic appointments. In turn improving patient outcomes and cost savings.
Patients would only be eligible when attending one site within the NHS Trust due to availability of DTS. Patients would be referred from A&E and UTC with suspected scaphoid fractures and undergo the routine plain film imaging as well as a DTS examination, the results of the DTS will be interpreted by a Radiologist and available at the patient's fracture clinic appointment.
REC name
London - Central Research Ethics Committee
REC reference
23/LO/0653
Date of REC Opinion
5 Sep 2023
REC opinion
Further Information Favourable Opinion