COMPARATIVE STUDY OF DIGITAL VS CONVENTIONAL RADIOGRAPHY IN DETECTING SUBTLE FRACTURES
Keywords:
Digital radiography, Conventional radiography, Subtle fractures, Diagnostic accuracy, Image quality, Trauma imaging, Radiology.Abstract
Background: X-rays are still the principal imaging technique used at the initial assessment of fractured bones. The identification of subtle fractures is somewhat difficult, however, especially if the fracture line is small, little displaced, and in an anatomically complex area. The digital radiography has been replacing the film-based radiography over the years as the image processing and workflow have improved.
Objective: The aim of this study was to compare the diagnostic ability of conventional and digital radiography in detecting subtle fracture.
Study Type: Comparative Study
Methods: Comparative diagnostic study was done in the Radiology Department of a tertiary hospital in Multan. A total of 180 patients were included who had a clinical suspicion of fractures. Both digital and conventional radiography techniques were used for radiographic examinations. The images were assessed by expert radiologists for diagnosis of fractures and reported on image quality assessment. Diagnostic parameters were computed such as sensitivity, specificity, accuracy and fracture detection rate. The image quality was evaluated according to pre defined criteria that were based on anatomical visibility and diagnostic acceptability.
Results: Of 180 patients, 96 patients (53%) had a diagnosis of subtle fracture confirmed. The 89 fractures were identified using digital radiography, and 76 fractures were identified using conventional radiography. The sensitivity of digital radiography was greater than conventional radiography (92.7% vs 79.2%). Additionally, digital radiography showed higher specificity (95.1%), overall accuracy (93.9%) and image quality scores than conventional radiography. Better identification of subtle fracture findings was facilitated by improved visualization of the cortical margins, trabecular details and soft tissue contrast. There was greater observer agreement in diagnoses of digital radiography, with more uniformity among radiologists.
Conclusion: The diagnosis of subtle fractures using digital radiography was equivalent to that of conventional radiography. Digital systems offer potential important clinical benefits for trauma and orthopedic imaging, such as improved image quality and better visualization of fractures. The use of digital radiography in tertiary health care could enable earlier diagnosis and better management of patients.
