Diagnostic accuracy of digital imaging and computed tomography in calcaneal fracture evaluation

Background: Initially, suspected calcaneal fractures are typically evaluated using conventional radiography. However, contemporary classification systems for calcaneal fractures rely heavily on computed tomography (CT) due to its ability to provide three-dimensional imaging, which offers a more comprehensive assessment than traditional two-dimensional plain radiography. This study aimed to investigate and compare the diagnostic efficacy of digital X-ray imaging versus computed tomography in evaluating calcaneal fractures. Methods: This study was conducted S.M.S Medical College Jaipur on 40 patients with isolated calcaneal trauma and was diagnosed radiologically by plain X-ray and CT to have calcaneal fractures. lateral view images was obtained to measure the Böhler’s angle, the angle of Gissane, the inclination angle and the facet height. Each angle was measured by two different interpreters (a senior radiologist and a resident) in order to verify accuracy. Results: A statistically significant difference was observed between Digital X-ray and CT image findings in both intra-articular fractures and total fractures. Specifically, significant differences were noted in the measurements of Bohler's angle, the angle of Gissane and facet height, whereas no significant difference was found in the inclination angle. These findings highlight the superior diagnostic accuracy of CT imaging in assessing calcaneal fractures. Conclusions: Computed Tomography (CT) scanning has emerged as a indispensable, non-invasive diagnostic tool, widely adopted for its exceptional utility in accurately identifying, classifying and informing treatment strategies for both extra-articular and intra-articular calcaneal fractures, thereby revolutionizing the management of these complex injuries.