The anatomical fat pad and the radiological "scaphoid fat stripe"

The diagnostic value of the "scaphoid fat stripe" seen on X-rays in association with fractures of the scaphoid bone in the wrist is reviewed. The anatomical basis for these soft tissue radiological changes was investigated by dissection of the anatomical snuff-box and by injection studies. It is concluded that the snuffbox fat is part of a major fat-pad located in a recess radio-dorsally on the wrist. However the radiological structure named the "scaphoid fat stripe" was found to be the highly radiolucent common tendon sheath of the extensor pollicis brevis and the abductor pollicis longus muscles. Limitations in diagnostic sensitivity and specificity are discussed.