Comparison of Conventional Radiography and Multidetector Computed Tomography Scan in Knee Trauma in Rajavithi Hospital

Objective: This study aimed to compare the diagnostic results and agreement among XR, MDCT, and combined examination between XR and MDCT in diagnosing knee bone fractures.

Methods: A retrospective was conducted of 243 patients who experienced knee trauma and underwent both XR and MDCT scans between January 1, 2016, and January 1, 2021, at Rajavithi Hospital in Bangkok, Thailand.

Results: Out of the 243 patients, 147 were male (60.5%), and 96 were female (39.5%), with 226 (93%) displaying fractures. MDCT identified a total of 319 fractures in various anatomic regions. Computed tomography scans compared with the two combined methods showed no difference in results. However, the radiography results were significantly different compared to the two methods combined (p<0.05). MDCT+XR proved more effective in diagnosing fractures than XR alone. The agreement between MDCT versus MDCT+XR exceeded 0.98, whereas the agreement between XR versus MDCT+XR was less than 0.9, except for femoral fractures (0.935). Overall, utilizing both MDCT and XR together significantly enhanced the diagnostic effectiveness compared to using XR alone.

Conclusion: MDCT imaging provides more accurate results, while XR imaging is still valuable for certain fractures. The combined methods were more accurate, especially in cases where the fracture type and characteristics cannot be determined with XR alone. The high level of agreement between XR and MDCT supports the combined use of both methods in clinical practice for diagnosing knee injuries.