X Shades of Gray – The Role of the Imaging Monitor in the Accuracy of Diagnosis of Occult Scaphoid Fractures – A Pilot Study

Introduction: Most hospitals and clinics utilize non-medical grade displays for viewing radiographs wrist. The aim of this study was to compare the rates of scaphoid fracture diagnosis by nonmedical grade Vs medical grade displays.
Methods: wrist radiographs of consecutive patients from our institution that had a clinical signs of scaphoid fracture without findings on plain radiography (suspected scaphoid fractures) were retrospectively interpreted for radiographic signs of fracture by two senior hand specialists, a hand fellow, and a non hand orthopedic specialist, on non medical grade and medical grade displays. The difference in fracture diagnosis rates was studied. Kappa statistics were used concerning the opinions of the four observers.
Results: One hundred and seventy-five wrist radiographs were interpreted.
Mean 48.25 (27%) scaphoid fractures were observed on non-medical grade display Vs 66 (38.2%) on medical grade display (p=0.076).
Discussion: No significant statistical differences in scaphoid fracture detection were found between the different displays.
We showed that there is a higher rate of scaphoid fracture diagnosis when the X-rays are evaluated on a medical grade display.
Conclusion: The scaphoid fracture detection rate on the nonmedical grade display was found to be higher with medical grade displays.
Utilizing medical grade displays can increase the rate of diagnosis in cases of clinically suspected scaphoid fractures.