Scaphoid bone bruising--probably not the precursor of asymptomatic non-union of the scaphoid.
The MRI finding of bone marrow oedema, without fracture, following trauma to the scaphoid has been called a 'bone bruise'. A similar injury is found in the knee, considered benign and managed conservatively. In the scaphoid, there is the concern that this lesion may lead to scaphoid non-union. This study addresses that concern. The clinical and radiological findings of 41 patients with a scaphoid bone bruise on MRI are described, an MRI classification system proposed and clinical outcomes investigated. Patients were immobilised for 6 weeks. At 3 months, 8 remained symptomatic and had repeat MRI. Four of these showed complete resolution of the bruise, the others improvement. At 6 months, 2 of the 8 complained of minor, intermittent discomfort but progressed to resolution of symptoms. This study suggests that the scaphoid bone bruise is a benign injury with predictable recovery and is unlikely to result in long-term morbidity in the form of non-union.
La Hei
N
N
Department of Orthopaedics, Cheltenham General Hospital, UK. ianina@doctors.org.uk
McFadyen
I
I
Brock
M
M
Field
J
J
D000293:Adolescent; D000328:Adult; D001853:Bone Marrow / Q000293:injuries; D002648:Child; D003288:Contusions / Q000150:complications*; D004487:Edema / Q000150:complications / Q000175:diagnosis; D005260:Female; D005599:Fractures, Ununited / Q000150:complications*; D006801:Humans; D007103:Immobilization; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D021361:Scaphoid Bone / Q000293:injuries*; D014954:Wrist Injuries / Q000628:therapy