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01.12.2016 | Research article | Ausgabe 1/2016 Open Access

Journal of Orthopaedic Surgery and Research 1/2016

CT-generated radiographs in patients with pelvic ring injury: can they be used in lieu of plain radiographs?

Journal of Orthopaedic Surgery and Research > Ausgabe 1/2016
Adham A. Abdelfattah, Berton R. Moed
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

Please note that both authors (AAA and BRM) (1) made substantial contributions to the conception, design, analysis and interpretation of the data; (2) were involved in drafting the manuscript and revising it critically for important intellectual content; (3) have given final approval of the version to be published; and (4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. AAA acquired the data.



Pelvic ring injury classification traditionally is made using plain radiographs. Recent studies suggest that computed tomography (CT)-generated images have higher diagnostic accuracy than plain films for the classification of acetabular fractures. However, similar studies have not been performed for pelvic ring injuries. The purpose of this study was to compare CT-generated and plain radiographs in terms of the ability of surgeons at different experience levels to identify pelvic injury type.


CT-generated and plain radiograph image sets were created from 15 pelvic ring injury patients with known classification morphology. Three groups, each consisting of three orthopaedic surgeons representing different levels of expertise, viewed these image sets and recorded their diagnoses. These diagnoses were compared to the gold standard findings of the treating physician and to each other.


Overall, there was a significantly improved ability to correctly classify pelvic ring injury type by CT-generated radiographs as compared to plain radiographs (p < 0.01). However, analysis of the groups revealed that this difference was limited to the less experienced groups (p < 0.05).


CT-generated radiographs are diagnostically beneficial for less experienced surgeons and at least as good as conventional plain radiographs for experienced surgeons in classifying pelvic ring injuries. Therefore, CT-generated radiographs may be clinically valuable: sparing the patient additional radiation exposure and discomfort by avoiding the reordering of plain radiographs when the initial studies are of poor quality, as well as serving as a possible alternative for supplemental initial injury plain radiographic views.
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