Journal Article Ahead of print
PubMed: 42277387 DOI: 10.1007/s00330-026-12629-x
Interdisciplinary consensus statements on imaging of scaphoid fractures.
Eur Radiol
Authors: Tobias Johannes Dietrich, James Teh, Rainer Schmitt, Alain Blum, Nina Hesse, Radhesh Krishna Lalam, Andoni Paul Toms, Fabio Becce, Patrick Omoumi, Maryam Shahabpour, Maciej Bień, Marco Zanetti, Robert Downey Boutin, Jan Fritz, Eva Llopis, Alberto Bazzocchi, P Diana Afonso, Vasco V Mascarenhas, Reto Sutter, Anne Cotten, Jean-Luc Drapé, Guillaume Bierry, Grzegorz Pracoń, Milko C de Jonge, Danoob Dalili, Marc Mespreuve, Maciej Klich, Ladislav Nagy, Robert M Szabo, Jörg G Grünert, Emmanuel J Camus, Gregory Ian Bain, Christophe L Mathoulin, Florian Goehtz, Marc Garcia-Elias, Luc Van Overstraeten, Francisco Del Piñal, Andrea Atzei, Riccardo Luchetti, Adrian Julian Chojnowski, Piotr Czarnecki, Fernando Corella, Michiro Yamamoto, Igor O Golubev, Jörg van Schoonhoven, Luis Cerezal, Iwona Sudoł-Szopińska
Affiliations
- HOCH, Cantonal Hospital St. Gallen, Radiology and Nuclear Medicine, St. Gallen, Switzerland.
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
- Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK.
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
- Department of Radiology, University Hospital Würzburg, Würzburg, Germany.
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, UDL, Nancy, France.
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK.
- Norwich Medical School, University of East Anglia, Norwich, UK.
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Radiology, Hôpital Universitaire de Bruxelles-Bordet, Université Libre de Bruxelles, Brussels, Belgium.
- Gamma Medical Center, Warsaw, Poland.
- Faculty of Medicine, University of Zurich, Zurich, Switzerland.
- Radiology, Kantonsspital Baden, Baden, Switzerland.
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Radiology, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
- Hospital de la Ribera. IMSKE, Valencia, Spain.
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
- Hospital CUF Tejo, Grupo CUF, Lisbon, Portugal.
- Hospital Particular da Madeira, HPA, Madeira, Portugal.
- Musculoskeletal Imaging Unit, Hospital da Luz, Lisbon, Portugal.
- Imaging Department, Universidade Católica Portuguesa, Católica Medical School, Lisbon, Portugal.
- Imaging, Joaquim Chaves Saúde, Lisbon, Portugal.
- Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- Musculoskeletal Imaging Department, CIAL, Lille University, Lille, France.
- Service de Radiologie B, Groupe Hospitalier Cochin, AP-HP.Centre, Université Paris Cité, Paris, France.
- MSK Imaging, University Hospital, Strasbourg Cedex, France.
- Department of Radiology, St. Antonius Hospital Utrecht, Utrecht, The Netherlands.
- Radiology Department, Dorking Road, Epsom & St Helier University Hospitals NHS Trust, London, UK.
- Department of Medical Imaging, University Hospital Ghent, Ghent, Belgium.
- Specjalistyczna Praktyka Lekarska Chirurgia Ręki Maciej Klich, Warsaw, Poland.
- Division for Hand Surgery and Surgery of Peripheral Nerves, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- Department of Orthopaedic Surgery, University of California Davis, Health System, Sacramento, CA, USA.
- Department of Hand and Plastic Surgery, Berit Klinik, Goldach, Switzerland.
- Brussels Free University (ULB), Brussels, Belgium.
- Hand Surgery Unit, IMPPACT Group, Lesquin, France.
- Hand Surgery Unit, IMPPACT Group, Polyclinique du Val de Sambre, Maubeuge, France.
- Department of Orthopaedic Surgery, Flinders University of South Australia and Flinders Medical Centre, Adelaide, SA, Australia.
- International Wrist Center, Clinique Bizet, Paris, France.
- Clinic for Hand Surgery, Rhön Medical Center, Bad Neustadt/Saale, Germany.
- Hand and Upper Extremity Surgery, Creu Blanca, Barcelona, Spain.
- Hand and Foot Surgery Unit (HFSU) SPRL, Tournai, Belgium.
- Department of Orthopaedics and Traumatology, Erasme University Hospital, Brussels, Belgium.
- Instituto de Cirugía Plástica y de la Mano, Madrid, Spain.
- Pro-Mano, Treviso, Italy and Ospedale San Camillo, Treviso, Italy.
- Rimini Hand Surgery and Rehabilitation Center, Rimini, Italy.
- Orthopaedics and Trauma Department, Hand and upper limb surgery, Norfolk and Norwich University NHS Trust Hospital, Norwich, UK.
- Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, Poznań, Poland.
- Spain- Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, Madrid, Spain.
- Hand Surgery Unit. Hospital Universitario Quirónsalud Madrid, Madrid, Spain.
- Surgery Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
- Department of Human Enhancement and Hand Surgery, Nagoya University, Nagoya, Japan.
- National Medical Research Centre of Traumatology and Orthopaedics named after NN Priorov Hand Trauma and Microsurgery Division, Moscow, Russia.
- Radiology Department, DMC-Diagnóstico Médico Cantabria, Santander, Spain.
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Abstract
OBJECTIVES
To establish evidence-based consensus statements on imaging of scaphoid fractures.
MATERIALS AND METHODS
Nineteen hand surgeons formulated a preliminary list of eleven questions on imaging of scaphoid fractures. Based on this preliminary list, radiologists crafted statements considering literature and their clinical experience, then refined them through an iterative Delphi process to revise the questions and statements. A maximum of three Delphi rounds was scheduled until group consensus was achieved for an individual statement, whichever arose first. Twenty-eight radiologists drafted the statements and acted as Delphi panellists. Panellists rated their level of agreement with each statement on an 11-point numeric rating scale, the score '0' indicated complete disagreement and the score '10' indicated complete agreement, respectively. Group consensus was specified as a score of '8' or higher for ≥ 23/28 panellists.
RESULTS
Eight of eleven questions and statements achieved group consensus in the first Delphi round. The remaining three questions and statements achieved group consensus in the second Delphi round, indicating more controversial topics. It was agreed that radiographs are the initial imaging technique of choice for suspected scaphoid fractures. MRI or CT are advocated for suspected radiographically occult scaphoid fractures. CT is the method of choice for assessment of osseous consolidation. Contrast-enhanced MRI is the preferred imaging modality for assessing vascularisation of scaphoid nonunion. CT is the most valuable technique in the postoperative evaluation of scaphoid fractures.
CONCLUSION
Delphi-based consensus statements suggest imaging pathways to diagnose scaphoid fractures, assess osseous fracture consolidation and evaluate pre- and postoperative fractures.
KEY POINTS
Question How can an international and interdisciplinary team of hand surgeons and musculoskeletal radiologists develop practical consensus statements on imaging of scaphoid fractures? Findings All eleven statements achieved group consensus among experts using the Delphi technique for consensus-building. Imaging pathways were suggested to diagnose and assess scaphoid fractures. Clinical relevance statement International, interdisciplinary and evidence-based consensus statements on imaging of scaphoid fractures were achieved using the Delphi technique. The focus of the statements was to diagnose scaphoid fractures, assess osseous fracture consolidation and evaluate pre- and postoperative fractures.
MeSH
Radiologists, Radiography, Diagnosis, Surgeons