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Detection of occult wrist fractures by magnetic resonance imaging
W C Peh1, L A Gilula, A J Wilson
1Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Abstract:
The early detection and management of wrist fractures may avert potential complications and patient morbidity. Five cases are described in which radiographically-occult fractures were clearly demonstrated by magnetic resonance imaging (MRI). These fractures were seen on MRI as a low signal linear band on T1- and T2-weighted images, with surrounding increased signal intensity from bone marrow oedema on T2-weighted images. In one case, intense oedema obscured the fracture line on the initial MR scan. MRI is useful in confirming the presence of a fracture, delineating its exact shape and location, and in the follow-up of these injuries during and after treatment.
Insights
Early detection of wrist fractures using magnetic resonance imaging (MRI) can prevent complications. MRI clearly shows fractures missed on X-rays, aiding diagnosis and treatment.
Area of Science:
- Orthopedic surgery
- Radiology
- Medical imaging
Background:
- Wrist fractures are common injuries.
- Early diagnosis and management are crucial to prevent complications and reduce patient morbidity.
- Radiographically-occult fractures can be challenging to detect using conventional imaging.
Observation:
- Five cases of radiographically-occult wrist fractures are presented.
- Magnetic resonance imaging (MRI) was used to demonstrate these fractures.
- Fractures appeared as low signal linear bands on T1- and T2-weighted MRI sequences.
Findings:
- Bone marrow edema surrounding the fracture line showed increased signal intensity on T2-weighted images.
- In one case, intense edema initially obscured the fracture line on MRI.
- MRI confirmed the presence, shape, and location of occult fractures.
Implications:
- MRI is a valuable tool for diagnosing wrist fractures that are not visible on X-rays.
- Accurate fracture delineation by MRI aids in appropriate treatment planning.
- MRI can be used for monitoring fracture healing and treatment progress.