{"id":6103,"date":"2025-04-17T09:45:01","date_gmt":"2025-04-17T09:45:01","guid":{"rendered":"https:\/\/integratedcarejournal.com\/?p=6103"},"modified":"2025-04-17T09:46:07","modified_gmt":"2025-04-17T09:46:07","slug":"reducing-misdiagnosis-helping-patients-back-work","status":"publish","type":"post","link":"https:\/\/integratedcarejournal.com\/reducing-misdiagnosis-helping-patients-back-work\/","title":{"rendered":"Reducing misdiagnosis and helping patients back to work"},"content":{"rendered":"

Scaphoid fractures are notoriously difficult to diagnose, typically presenting among young men following a fall onto an outstretched hand, car accident or contact sport incident. One of eight small bones that make up the \u2018carpal bones\u2019 of the wrist, the scaphoid connects two rows of bones: one closer to the forearm and the other closer to the hand. These fractures can present with wrist or thumb pain but not necessarily any visible deformity or significant loss of motion, leading many incidences to be misdiagnosed as wrist sprains.<\/p>\n

The scaphoid bone has an avascular blood supply that means, depending on the location and size of the break, there is a real risk of bone death where blood supply is cut off. This leads to a loss of wrist function and dexterity, which can have significant financial implications for those who rely on their flexibility of wrist movement that the scaphoid supports.<\/p>\n

This is why MRI and CT images have become the \u2018gold standard\u2019 for diagnosis. However, limited resources and long imaging waiting lists mean clinicians across the UK instead rely on X-rays in the first instance. If a scaphoid fracture is suspected, clinicians will typically request four X-ray views, versus two for other wrist injuries, but even that is not a guarantee that the fracture will show as the scaphoid bone can be easily hidden by other carpal bones in a 2D image.<\/p>\n

\"\"<\/a>
Traditional 2D film X-ray radiograph showing broken carpal bone (scaphoid fracture)<\/em><\/figcaption><\/figure>\n

It is easy to understand how scaphoid fractures can be easily missed then, particularly in overstretched A&E departments where there may not be sufficient scanner time or radiology cover to diagnose \u2018minor injuries\u2019 quickly. Clinical teams usually adopt a conservative approach therefore: Initially treating the injury as if the bone is fractured, with splinting recommended to protect it from further damage, and a follow-up appointment with the fracture clinic in 7-10 days\u2019 time. By this point, if the patient is still experiencing pain, new X-rays will likely reveal initial bone healing more clearly than the original scaphoid break.<\/p>\n

It is a sensible approach but one that ultimately causes several problems:<\/p>\n

Firstly, where clinicians are concerned about the possibility of a scaphoid fracture but unable to confirm it during the initial visit, splinting the wrist while awaiting further imaging or specialist review means patients can find themselves unable to work unnecessarily, with significant financial implications due to lost earnings.<\/p>\n

Scaphoid fractures are usually slow to heal because tiny blood vessels supplying nutrients to the site are often damaged at the time of injury. This means that even though the results of both surgical and non-surgical interventions are very good following diagnosis, both approaches require considerable time in plaster, with knock-on impacts for patients and their dependents, including inability to drive, work and earn normally. Should surgery ultimately be required, it is easy to see how treatment delays of just a couple of weeks can have a real impact on patients\u2019 lives.<\/p>\n

Finally, requiring all patients to attend follow-up appointments in fracture clinic has significant resource implications for a healthcare system already under pressure, not least in terms of clinician time and additional imaging requirements.<\/p>\n

Improving diagnosis through next-gen imaging<\/h3>\n

Accepting all of the above, how then can we improve diagnosis for these patients? How can we prevent patients with sprained wrists taking unnecessary time off work, while supporting those with scaphoid fractures to access faster treatment and limit injury-related loss of earnings?<\/p>\n

One potential solution lies in a new imaging technology \u2013 already proven in the veterinary industry \u2013 which promises to bring affordable, more-detailed 3D imaging to the point of care in hospitals and clinics around the world.<\/p>\n

This next-generation technology builds on the foundations of digital tomosynthesis (DT) imaging, which is widely used for breast imaging across the NHS. With traditional DT, a conventional X-ray tube moves through a range of angles to derive 3D data \u2013 providing better diagnostic information than 2D X-ray but, restricted by its limited depth resolution capabilities, creating difficulties localising some structures and elements.<\/p>\n

Adaptix\u2019s unique 3D X-ray technology \u2018sweeps\u2019 in two dimensions, enhancing the Z resolution relative to conventional DT. Images are quickly reconstructed \u2013 in under 20 seconds \u2013 providing\u00a0slice-by-slice images that can be analysed extremely quickly. This allows for slice thickness adjustments over regions of interest \u2013 a particularly important feature when looking for \u2018tricky\u2019 fractures, such as those to the scaphoid bone.<\/p>\n

The result? A high-resolution 3D image that provides far greater definition and clarity than 2D X-ray techniques, at a cost and radiation dose similar to traditional X-ray. What is more, the compact design of the technology and low-radiation dose, mean it can be brought directly to the point of patient care \u2013 reducing time spent moving between hospital departments and allowing clinicians to obtain imaging \u2018in clinic\u2019 if needed.<\/p>\n

\n

About the author<\/h3>\n

Mark Thomas, BSc (Hons), PgC, HCPC Reg., Product Manager, Adaptix<\/em>\u00a0<\/em><\/p>\n

Mark spent the first 10 years of his career working as a Radiographer in human healthcare both in the UK and Australia. Later, he focused on CT, managing the Neuro CT Service in Oxford in his final position. In 2008, Mark joined Toshiba\/Canon Medical as a CT Specialist, and spent the next 15 years initially providing training, before managing the UK Clinical CT Team. With a strong team Mark drove the adoption of new technologies pushing clinical boundaries, maintaining high clinical integrity and importantly customer satisfaction. Mark’s background gives him real clarity on the future and opportunity for inclusion of Digital Tomosynthesis Imaging in a modern, forward thinking Imaging Service.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

New imaging technology promises to bring affordable, more detailed 3D imaging to care settings around the world, providing faster and more accurate diagnosis and helping patients get the right care. <\/p>\n","protected":false},"author":187,"featured_media":6107,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[44,25,62],"tags":[],"class_list":["post-6103","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured","category-news","category-secondary-care"],"acf":[],"_links":{"self":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/6103","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/users\/187"}],"replies":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/comments?post=6103"}],"version-history":[{"count":4,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/6103\/revisions"}],"predecessor-version":[{"id":6109,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/posts\/6103\/revisions\/6109"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/media\/6107"}],"wp:attachment":[{"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/media?parent=6103"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/categories?post=6103"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/integratedcarejournal.com\/wp-json\/wp\/v2\/tags?post=6103"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}