Low Positive Predictive Value of Bone Scan to Predict Impending Complete Fracture among Incomplete Atypical Femoral Fracture
- Authors
- Lee, Young-Kyun; Lee, You Jin; Lee, Na Kyoung; Nho, Jae-Hwi; Koo, Kyung-Hoi
- Issue Date
- 28-May-2018
- Publisher
- 대한의학회
- Keywords
- Atypical Femoral Fracture; Bone Scan, Prophylactic Fixation; Impending Fracture; Femur
- Citation
- Journal of Korean Medical Science, v.33, no.22
- Journal Title
- Journal of Korean Medical Science
- Volume
- 33
- Number
- 22
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/5964
- DOI
- 10.3346/jkms.2018.33.e157
- ISSN
- 1011-8934
1598-6357
- Abstract
- Background: Although bone scan might be useful to detect incomplete atypical femoral fractures (AFFs) earlier than radiographs, there is no study on predicting further progression to a complete fracture among incomplete AFFs. Our purposes are to determine whether bone scan detects impending complete fracture among incomplete AFFs. Methods: We reviewed 18 patients (20 AFFs) who underwent bone scan at the diagnosis of incomplete AFF and were not treated with prophylactic fixation. A diagnosis of imp ending complete fracture was made, when the femur completely fractured within 6 months after the scan. We correlated radioisotope uptake with the impending complete fracture to calculate sensitivity, specificity, positive predictive value and negative predictive value ofbone scan. Results: Thirteen AFFs (65%, 13/20) showed a positive uptake in bone scan. Among the 13, only one femur was completely fractured within 6 months. None of the 7 femurs without uptake in bone scan fractured. In diagnosing impending complete fracture, the sensitivity ofbone scan was 100% and negative predictive value was 100%. However, the specificity (36.8%) and positive predictive value (7.7%) were quite low. Conclusion: Bone scan has no significant role in detecting the impending complete fracture, and a positive uptake does not mean the necessity of prophylactic fixation of incomplete AFF.
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Collections - College of Medicine > Department of Orthopedic Surgery > 1. Journal Articles
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