Skeletal scintigraphy of the wrist in suggested scaphoid fracture

Skeletal scintigraphy was performed in 187 patients with clinical suspicion of a scaphoid fracture but with normal radiographic findings. In 85 patients focally moderately (12 patients) or markedly to intensely (73 patients) increased radionuclide uptake was seen, over either the distal radius or carpal bones. A fracture corresponding to markedly increased uptake was eventually verified in 15 out of 26 patients in the distal radius, in 21 out of 28 in the scaphoid but in only 6 out of 18 in other carpal bones. One fracture of the body and one of the hook of the hamate were found, one fracture of the capitate and three of the triquetrum. Not a single fracture was verified in 10 patients with markedly, often intensely, increased activity over the trapezium/trapezoid. It is concluded that scintigraphy is of value in carpal trauma not only to exclude scaphoid fracture but also to direct the attention to the possibility of other carpal fractures, otherwise usually missed.