Radiography of the carpal scaphoid. Experimental evaluation of "the carpal box" and first clinical results.
OBJECTIVE
The authors describe a new device ("the carpal box") for the radiographic detection of occult scaphoid fracture.


METHODS
Fractures in the scaphoid of five cadaver specimens were mechanically produced. Subsequent examinations included conventional scaphoid radiography, multi-angle radiography, and radiography using the new device. The anatomic analysis of the specimens served as the standard for comparison. A pilot study was performed in six consecutive patients with suspected scaphoid fracture.


RESULTS
Neither scaphoid radiography nor multi-angle radiography could confirm a fracture in two specimens, whereas all fractures were recognized on the carpal box radiographs. All scaphoid fractures were visualized by carpal box radiography, whereas scaphoid radiography was equivocal in one patient and negative in the other.


CONCLUSIONS
Carpal box radiography may have additional value in the diagnosis of occult scaphoid fracture. This may lead to a reduction in costs and inconvenience for patients with clinically suspected scaphoid fracture and negative scaphoid radiography.
Tiel-van Buul
M M
MM
Department of Nuclear Medicine, University of Amsterdam.
van Beek
E J
EJ
Dijkstra
P F
PF
Bakker
A D
AD
Griffioen
F M
FM
Broekhuizen
T H
TH
D002348:Carpal Bones / Q000000981:diagnostic imaging* / Q000293:injuries; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006801:Humans; D066298:In Vitro Techniques; D010865:Pilot Projects; D011859:Radiography / Q000295:instrumentation*