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Diagnostic Value of Imaging Modalities for Suspected Calcaneal Fracture: A Systematic Review of Literatures

Firooz Madadi, Firoozeh Madadi, Ali Sanjari Moghaddam

Background: Calcaneal fracture account as the most common tarsal bones injury. Diagnosis of fracture is based on X-rays radiological studies, but CT-scan is the most reliable tool for diagnosis of calcaneus fracture. In this study, we conducted a systematic review, which will help readers to get a better view of usefulness of different imaging modality in diagnosis of calcaneal fracture.
Methods: We conducted a systematic review based on PRISMA protocol. To find all citations, PubMed /Medline, ISI web of knowledge, EMBASE and Cochrane library databases were searched from their beginning to June 2015. Two authors, applying the inclusion and exclusion criteria, screened all citations and abstracts and extracted all needed information from included literatures, independently. In order to assess the quality of included studies, QUADAS was used.
Results: Ten literatures included in this systematic review. Sensitivity of different conventional radiographs ranged from 0% for Foot posteroanterior to 100% for Foot reversed oblique and Combined Lateral and axial calcaneal X-ray. Specificity of conventional radiographs ranged from 72% for lateral calcaneal X-ray to 100% for Lateral foot or ankle radiograph. For the CT-scan, three-dimensional (3D) shaded radiographs had highest sensitivity (90.7%) and specificity (93.9%). Four studies tried to show value of angle’s measures in diagnosis of calcaneal fracture that had different results. Conclusions: We concluded that there are few literatures evaluating different imaging modality in diagnosis of calcaneal fracture and results are not enough to prove advantage of one modality to others. So, one study with a large population sample is needed to compare diagnostic value of different modalities.