Keywords:
Trauma, Diagnostic procedure, MR, Musculoskeletal system, Musculoskeletal soft tissue, Musculoskeletal bone
Authors:
I. Katsimilis, N. Purohit, L. King, M. Sampson, V. T. Skiadas; Southampton/UK
DOI:
10.1594/essr2015/P-0096
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 patients 14 had incidental dorsal or volar ganglia.
MRI depicted a scaphoid fracture in 21 patients (Fig. 1).
From these patients 8 had co-existent bony injuries (contusions,
fractures) at adjacent bones (trapezium,
distal radius,
capitate).
In 18 cases MRI revealed either an isolated carpal bone fracture or a combination of bony injuries other than scaphoid.
In particular 5 patients had distal radius undisplaced fractures (Fig. 2),
4 patients had trapezium fractures (Fig. 3),
4 patients had capitate/hamate fractures (Fig. 4 ,
Fig. 5 ,
Fig. 6 ,
Fig. 7),
3 patients had lunate fractures/injuries alone or in combination with distal radius and triquetrum injuries,
1 patient had triquetrum fracture (Fig. 8) and 1 patient had injuries in multiple carpal bones (Fig. 9 ,
Fig. 10).
19 patients had only soft tissue injuries mainly extrinsic dorsal ligament sprains (Fig. 11 ,
Fig. 12).
8 of these patients had also scapholunate ligament injuries (Fig. 13).
2 patients presented with De Quervain’s tenosynovitis (Fig. 14).
3 patients had STT joint and 1st CMC joint active degenerative changes.
4 patients had evidence of ulnar abutment syndrome (Fig. 15) and 2 patients had triangular fibrocartilage injuries (Fig. 16) with or without other injuries.
On balance MRI depicted a scaphoid fracture in 21 patients.
35 cases were negative.
In 18 cases MRI revealed either an isolated carpal bone fracture or a combination of bony injuries,
other than scaphoid. In 19 patients isolated ligamentous injuries were identified.
In 11 patients other pathologic conditions were noted that could explain the patient’s ongoing symptom (Fig. 17).