Learning objectives
The purpose of this study is mainly to analyse and present the MRI features of osseous and soft tissues abnormalities that can mimic clinically a scaphoid fracture in patients with negative or equivocal plain films after a FOOSH injury.
Background
The scaphoid bone is the most commonly fractured carpal bone.
It occurs most often in young adults,
mainly young active men.
The primary mechanism of injury is a fall on the outstretched hand with an extended and radially deviated wrist,
resulting in extreme dorsiflexion at the wrist and axial loading of the radial side of the hand.
Clinically it presents with radial sided wrist pain,
swelling,
anatomical snuffbox tenderness,
scaphoid tubercle tenderness and positive scaphoid compression test.
The differential diagnosis for suspected scaphoid fractures includes...
Imaging findings OR Procedure Details
Materials nad methods:
104 patients (60 females and 44 males) with persistent scaphoid tenderness after a FOOSH injury and a negative or inconclusive initial plain film underwent an MRI scan in our department within the last year.
The age of the patients ranged between 18 and 78-year-old.
Coronal T1w and STIR,
sagittal STIR and axial PD FS sequences were performed,
at a 1.5 T Siemens Aera and 1.5 Siemens Symphony Scanners with a dedicated wrist array coil.
Imaging findings:
35 scans were negative.
From these...
Conclusion
In our study MRI successfully depicted a number of occult scaphoid fractures but also various other clinically important carpal bone fractures or soft tissue injuries that can mimic a scaphoid fracture,
and thus changed our patient’s management.
References
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Diagnosis and management of scaphoid fractures.
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Cost-Effectiveness of Immediate MR Imaging versus...
