Incremental diagnostic yield of bone scintigraphy after standard radiologic imaging in patients with fall trauma at a Level I trauma center

Abstract

Objective This study aimed to evaluate the incremental diagnostic yield of bone scintigraphy (BS) performed after standard radiologic imaging (SRI) modalities, including radiography, computed tomography, and magnetic resonance imaging, in patients with fall trauma presenting to a Level I trauma center. Methods Three hundred eight patients with fall trauma who underwent BS after SRI were retrospectively enrolled. The presence and number of bone injuries across six skeletal regions were evaluated using both SRI and BS. Bone injuries were evaluated according to three imaging-based categories: SRI alone, SRI − /BS + , and SRI + BS. Imaging-derived bone parameters included the total number of regions with bone injuries, the total number of injured bones, and the Imaging Bone Index (IBI) score. Correlations between these imaging-derived bone parameters and four trauma scores were analyzed, and differences in imaging-derived bone parameters were examined according to the cutoff values of each trauma score. Results The imaging-derived bone parameters in the SRI + BS category were significantly higher than those in the SRI alone category. Imaging-derived bone parameters in both the SRI alone and SRI + BS categories showed significant correlations with all trauma scores, with significantly stronger correlations for the total number of injured bones and IBI scores in the SRI + BS category. Patients with severe trauma exhibited significantly higher imaging-derived bone parameters in the SRI − /BS+ category. Conclusions Performing BS after SRI provided incremental diagnostic yield by detecting additional bone injuries not identified on preceding SRI and yielded quantitative imaging-derived bone parameters associated with trauma severity in this Level I trauma center cohort of patients with fall trauma.