title: Radiographically occult scaphoid fractures: value of MR imaging in detection.
abstract: OBJECTIVE
  To evaluate the diagnostic value of magnetic resonance (MR) imaging in patients with clinical suspicion of scaphoid fractures and normal initial plain radiographs.
  
  
  METHODS
  MR imaging was performed within 7 days after trauma in 42 patients with clinical suspicion of scaphoid fractures and normal plain radiographs. T1-weighted spin-echo, T2*-weighted gradient-echo, and short inversion time inversion-recovery (STIR) sequences were performed. MR images were evaluated independently by two radiologists. Six-week follow-up radiographs were used as a standard to diagnose fractures.
  
  
  RESULTS
  MR imaging depicted occult fractures of the scaphoid bone in 14 patients (33%), the capitate bone in four (10%), the trapezium in one (2%), and the distal radius in two (5%). All wrist fractures were detected with a combination of STIR and T1-weighted spin-echo sequences. The sensitivity and specificity for detection of radiographically occult fractures of the wrist were 100% each for the first and 95% and 100%, respectively, for the second radiologist with an almost perfect interobserver agreement (K = 0.953).
  
  
  CONCLUSIONS
  MR imaging has a high sensitivity for detection of fractures of the scaphoid bone and wrist not evident on plain radiographs and may enable early diagnosis and treatment.
authors.affiliation: Department of Radiology, University of Vienna, Austria.
authors.forename: M J
authors.initials: MJ
authors.lastname: Breitenseher
authors.forename: V M
authors.initials: VM
authors.lastname: Metz
authors.forename: L A
authors.initials: LA
authors.lastname: Gilula
authors.forename: C
authors.initials: C
authors.lastname: Gaebler
authors.forename: C
authors.initials: C
authors.lastname: Kukla
authors.forename: D
authors.initials: D
authors.lastname: Fleischmann
authors.forename: H
authors.initials: H
authors.lastname: Imhof
authors.forename: S
authors.initials: S
authors.lastname: Trattnig
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D002648:Child; D005260:Female; D050723:Fractures, Bone / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography