Outcome of routine bone scintigraphy in suspected scaphoid fractures.
Undisplaced scaphoid fractures are easily missed on conventional scaphoid radiographs, but these occult fractures may seriously impair hand function. Routine bone scintigraphy (BS) is often advocated if there are clinical signs of a scaphoid fracture without radiological evidence. However, the results require careful therapeutic management.


OBJECTIVE
To determine the diagnostic value of BS in daily practice for clinically suspected scaphoid fractures.


METHODS
We evaluated our protocol of routine BS in suspected scaphoid fractures.


METHODS
In a retrospective study, we analysed 111 consecutive cases with signs of a scaphoid fracture on physical examination. Radiographs revealed 55 fractures, the remaining 56 patients all underwent BS.


RESULTS
On average, the BS was performed after 4 days. It showed a fracture in 38/56 of the patients. The distribution of fractures was: scaphoid bone 15, distal radius 11, other carpal bones 9 and metacarpal bones 3.


CONCLUSIONS
If there is a strong clinical suspicion of a scaphoid fracture, which cannot be confirmed by conventional radiology, BS is a valuable diagnostic tool.
Department of Traumatology, Medisch Centrum Haaglanden, The Hague, The Netherlands. f.j.p.beeres@umail.leidenuniv.nl
F J P
FJ
Beeres
M
M
Hogervorst
P
P
den Hollander
S
S
Rhemrev
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002985:Clinical Protocols; D004164:Diphosphonates; D005188:False Negative Reactions; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D021361:Scaphoid Bone / Q000000981:diagnostic imaging* / Q000293:injuries*; D017556:Technetium Compounds
D004164:Diphosphonates; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; C029045:technetium Tc 99m diphosphonate