1998 Fiscal Year Final Research Report Summary
Factors influencing radiographic detection of fractures in children
| Project/Area Number |
09670951
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Radiation science
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| Research Institution | Iwate Medical University |
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Principal Investigator |
EHARA Shigeru Iwate Med.Univ.Radiology Assoc.Prof., 医学部, 助教授 (50125506)
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| Project Period (FY) |
1997 – 1998
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| Keywords | Fractures / Radiography / ROC analysis / Radius / Humerus / Incomplete fractures / Epiphyseal plate |
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| Research Abstract |
Fractures in the region of the wrist and elbow are relatively common in children, but radiologic findings are often subtle. The purpose of this investigation was to assess the factors which influence detection of fractures on radiography in children.
At first, the role of clinical data on detection of fractures is assessed. Twenty cases of subtle fractures of the wrist in children at or younger than 15 years of age and 20 age-matched controls were interpreted in random fashion by three radiologists and two orthopedic surgeons. Using ROC analysis, clinical data contributed to improve detection of fractures by increasing true positive cases.
Second, differences between the cases of wrist fractures and elbow cases were evaluated. Fifteen subtle fractures of the elbow region and 15 age-matched control were interpreted by three radiologists, and the differences were compared. Although posterior fat pad sign was expected to contribute to detection, differences were not significant probably because quite subtle fractures were selected.
Third, effects of prevalence were tested. Two series of cases consisting of 30 wrist cases with 10 fracture cases (prevalence of 1/3) and 20 fracture cases (prevalence of 2/3) were evaluated by three radiologists. With higher prevalence, specificity increased, and sensitivity slightly decreased. This followed Bayeian theory.
The knowledge of the result will help avoid misdiagnosis and may be used in the education of residents.
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