Acute knee trauma: how many plain film views are necessary for the initial examination?

S D Gray, P A Kaplan, R G Dussault, R A Omary, S E Campbell, H B Chrisman, S F Futterer, J K McGraw, T E Keats, B J Hillman
Skeletal Radiology 1997, 26 (5): 298-302

OBJECTIVE: To determine whether anteroposterior (AP) and lateral views of the knee are equivalent to four views in acute fracture detection.

DESIGN: Three musculoskeletal radiologists retrospectively interpreted the plain film knee examinations of each patient, establishing ground truth for the presence or absence of a fracture. Cases were presented to four masked senior radiology residents twice--once as a two-view study and again as a four-view study--with 4 weeks separating the two reading sessions to minimize recall bias. Sensitivity, specificity, and diagnostic performance were calculated.

PATIENTS: Ninety-two patients presenting to the emergency department with acute knee trauma were evaluated with at least a four-view plain film examination.

RESULTS AND CONCLUSIONS: Mean sensitivity for fracture detection using four views (85%) was significantly higher than that using two views (79%). Mean specificity and receiver operating characteristic curve areas were not significantly different using two or four views. Four views are more sensitive than AP and lateral views alone in detection of acute knee fracture.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.