Unrecognized bone fractures of the extremities in Emergency Radiology: the invisible become visible on 3D 80 micron

In the last few years CBCT’s applications have expanded, especially in the field of musculoskeletal. In this study, we aim to analyze the diagnostic value and the use of CBCT in Emergency Radiology for the evaluation of extremity trauma.

The present retrospective study included a total of 72 distal limb trauma cases who were admitted in the Emergency Radiology Department of “Policlinico Riuniti di Foggia” during September 2022 to December 2023. All the cases required further medical diagnostic investigation after an initial examination CR. Among these, 12 were excluded for suspected poly-traumas and MDCT was directly performed. Of the 60, divided into 2 groups, 42 had negative or non-diagnostic CR result, and CBCT was performed as second-level exam, 18 with a fracture confirmed by CR underwent CBCT for surgical planning.

In the first group, 17 (40.5%) had negative CR results, and 25 (59.5%) had doubtful/non-diagnostic CR results. 25 (59.5%) presented a positive CBCT exam for fracture. In the second group, anyone required further diagnostic investigations for orthopedic surgery.

Thanks to high spatial resolution, low radiation dose, fast acquisition, and its three-dimensionality in space (3D), CBCT could be the first investigation in the cases of fractures clinically suspicious in locations with bone overlap.