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Understanding Pediatric Clinical Scaphoid Injuries: A Prospective Radiological Study
Kevin Cheung1, Holly Livock2, Zoe Rubin3,4
1Division of Plastic Surgery, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Plastic Surgery (Oakville, Ont.)
|May 12, 2025
Summary
In children with suspected scaphoid fractures and normal X-rays, advanced imaging like CT and MRI detected fractures in 36% of cases. Further research is needed to clarify the clinical importance of these findings.
Area of Science:
- Pediatric Orthopedics
- Radiology
- Musculoskeletal Imaging
Background:
- Management of pediatric scaphoid fractures with normal initial radiographs remains controversial.
- Clinical suspicion of scaphoid fracture in children often presents diagnostic challenges.
Purpose of the Study:
- To prospectively assess the utility of advanced imaging modalities in diagnosing scaphoid fractures in pediatric patients.
- To determine the prevalence of scaphoid fractures when initial radiographs are negative.
Main Methods:
- Children with suspected scaphoid fractures and two negative radiographic sets were enrolled.
- Participants underwent both computed tomography (CT) and magnetic resonance imaging (MRI) after casting.
- The primary outcome measured was the prevalence of confirmed scaphoid fractures.
Main Results:
- Nine out of twenty-five participants (36%) were diagnosed with a scaphoid fracture via CT or MRI.
- Computed tomography (CT) and magnetic resonance imaging (MRI) showed concordance in 64% of the evaluated cases.
- Advanced imaging identified fractures not apparent on initial radiographs.
Conclusions:
- A significant percentage of children with clinically suspected scaphoid fractures have confirmed injuries on advanced imaging.
- Further investigation is necessary to understand the clinical significance and optimal management of these injuries.
- The role of computed tomography (CT) and magnetic resonance imaging (MRI) in pediatric scaphoid fracture diagnosis warrants further study.
