Diagnostic problems of scaphoid fractures: the value of radionuclide bone scintigraphy

The diagnosis fracture of the scaphoid bone based on mere X-ray examination is unreliable. A correct diagnosis of scaphoid fractures is essential for the prevention of avascular necrosis of the proximal fragment and of pseudo-arthrosis. Thirty-three patients with a clinically suspected scaphoid fracture and a normal radiograph were examined. These patients had supplementary 99mTc-MDP scintigraphy. Eight of the 33 patients had normal scans, 12 patients had a scaphoid fracture and 17 had other fractures. Based on our findings, radionuclide bone scintigraphy is useful and accurate for the diagnosis or exclusion of fractures of the scaphoid and other carpal bones.