SUMMARY
The aim of the study was to comparatively evaluate the diagnostic value, sensitivity, and specificity of X-ray and computed tomography (CT) examinations in the diagnosis of extremity bone injuries of various etiologies. In addition, the influence of age, sex, trauma etiology, and isolated or combined character of injuries on the diagnostic informativeness of these methods was investigated. Material and Methods. The study was conducted between 2016 and 2021 in the traumatology and intensive care departments of the Clinical Medical Center in Baku. The instrumental examination results of 969 patients with different types of trauma were retrospectively analyzed. Digital X-ray examinations were performed in 362 (37.4%) patients, while CT examinations were carried out in 39 (4.0%) patients. Overall, extremity injuries were detected in 307 (31.7%) patients. The diagnostic informativeness of the methods was assessed based on sensitivity, specificity, false-positive, and false-negative results. Statistical analysis was performed using the SPSS-26 software package with Cohen’s Kappa coefficient (κ) and p-values. Results. The results demonstrated that the sensitivity and specificity of X-ray examination in detecting extremity trauma were 99.0% and 68.6%, respectively (κ=0.753; p<0.001). For CT examination, sensitivity was 97.1%, whereas specificity was 25.0% (κ=0.284; p=0.057). In male patients, X-ray examination showed higher diagnostic informativeness, while in female patients CT demonstrated 100% sensitivity. Age-group analysis revealed that CT provided superior diagnostic results in patients aged 50–59 years. In combined trauma cases, CT demonstrated a specificity of 100.0% and a sensitivity of 96.9%. X-ray examination showed particularly high sensitivity in traffic accidents and fall-related injuries. Conclusion. X-ray examination, due to its high sensitivity and accessibility, may be considered the primary screening method in the initial diagnosis of extremity trauma. CT, on the other hand, provides greater specificity and more detailed visualization in complex and combined injuries. Therefore, the choice of diagnostic method should be individualized according to trauma severity, localization of injury, patient age, and clinical condition.
Keywords: limb injuries, X-ray examination, computed tomography, diagnostic informativeness, skeletal trauma, comparative analysis

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