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Open AccessArticle

Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures

1
Department of Radiology, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
2
McMaster University Medical Centre, Hamilton Health Sciences, Hamilton, ON, USA
3
Department of Diagnostic Imaging, Juravinski Cancer Center, Hamilton Health Sciences, Hamilton, ON, USA
*
Author to whom correspondence should be addressed.
Tomography 2020, 6(3), 308-314; https://doi.org/10.18383/j.tom.2020.00031
Received: 11 June 2020 / Revised: 4 July 2020 / Accepted: 8 August 2020 / Published: 1 September 2020
Our institution recently implemented the use of digital tomosynthesis (DTS) to workup emergency room patients with suspected hip fractures after initial negative or indeterminate radiographs. Our purpose is to evaluate the diagnostic accuracy of DTS for hip fracture detection. We performed a retrospective review of all DTS studies over a 17-month period (July 2017 to November 2018). The results of the radiographs and DTS were recorded as either positive or negative for fracture based on the radiology report. Our reference standard for a fracture was either confirmation on subsequent CT or MRI from the same visit or documentation of clinical findings supportive of a fracture in the patient’s electronic medical record. For patients with negative DTS who did not undergo subsequent cross-sectional imaging, a missed fracture was excluded if they did not return within 30 days with a confirmed fracture. Among 91 patients, there were 34 confirmed fractures—sites including, 7 femoral necks, 10 pubic rami, and 7 greater trochanters. DTS was positive for fracture in 29 patients; 28 of these fractures were true positives, 6 confirmed on cross-sectional imaging, and 22 confirmed clinically. One false positive was observed in a patient with no clinical evidence of a fracture. Six fractures were not detected by tomosynthesis but confirmed on CT/MRI. The sensitivity and specificity of DTS are 82% and 98%, respectively, compared to that of radiographs alone at 47% and 96%, respectively. DTS is a promising adjunct to radiographs for hip fracture detection in an emergency department.
Keywords: hip fractures; digital tomosynthesis; emergency radiology hip fractures; digital tomosynthesis; emergency radiology
MDPI and ACS Style

Ozimok, C.; Koff, D.; Parasu, N. Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures. Tomography 2020, 6, 308-314. https://doi.org/10.18383/j.tom.2020.00031

AMA Style

Ozimok C, Koff D, Parasu N. Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures. Tomography. 2020; 6(3):308-314. https://doi.org/10.18383/j.tom.2020.00031

Chicago/Turabian Style

Ozimok, Cory; Koff, David; Parasu, Naveen. 2020. "Emphasizing the Diagnostic Value of Digital Tomosynthesis in Detecting Hip Fractures" Tomography 6, no. 3: 308-314. https://doi.org/10.18383/j.tom.2020.00031

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