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Imaging for Acute and Chronic Scaphoid Fractures
Kimberly K Amrami1, Matthew A Frick1, Jane M Matsumoto1
1Department of Radiology, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
Hand Clinics
|June 11, 2019
Summary
Radiographically occult scaphoid fractures are common and can lead to serious complications. Advanced imaging like CT and MRI offer more accurate and rapid diagnosis than X-rays, improving patient outcomes.
Area of Science:
- Orthopedic Surgery
- Radiology
- Medical Imaging
Background:
- The scaphoid bone is the most frequently fractured bone in the wrist.
- A significant percentage (20-40%) of scaphoid fractures are radiographically occult, meaning they are not visible on initial X-rays.
- Delayed diagnosis of scaphoid fractures can lead to severe complications, including nonunion, malunion, and avascular necrosis of the proximal pole.
Purpose of the Study:
- To review the diagnostic challenges posed by radiographically occult scaphoid fractures.
- To compare the efficacy of advanced cross-sectional imaging modalities (CT and MRI) versus conventional radiography for scaphoid fracture diagnosis.
- To discuss the evolving role of imaging techniques in the diagnosis and management of scaphoid fractures.
Main Methods:
- Review of current literature on scaphoid fracture diagnosis.
- Comparison of diagnostic accuracy and speed between conventional radiography, CT, and MRI for scaphoid fractures.
- Discussion of imaging modality selection based on clinical context and chronicity of the fracture.
Main Results:
- Conventional radiography has limitations in detecting early or subtle scaphoid fractures.
- Advanced imaging, specifically CT and MRI, demonstrates superior accuracy and speed in diagnosing radiographically occult scaphoid fractures.
- The choice of imaging modality for chronic fractures is guided by specific clinical questions.
Conclusions:
- Early and accurate diagnosis of scaphoid fractures is crucial to prevent long-term complications.
- CT and MRI are valuable tools for overcoming the limitations of radiography in diagnosing occult scaphoid fractures.
- Ongoing advancements in imaging technology promise further improvements in the diagnosis and treatment of scaphoid fractures.
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