Role of MRI in the diagnosis of clinically suspected scaphoid fracture: analysis of 611 consecutive cases and literature review.
BACKGROUND
A clinically suspected scaphoid fracture with normal initial plain x-rays is a difficult but common problem. The role of MRI as a diagnostic modality in this situation was analysed based on the experience of 611 consecutive cases.


METHODS
All patients presenting to the emergency department with a history of a fall on an outstretched hand and with tenderness over the anatomical snuff box and scaphoid tubercle but normal plain x-rays were offered MRI as part of the standard protocol. Between January 2003 and November 2005, 611 of a total of 619 such patients underwent the scan and form the study cohort. Coronal 3 mm T1 and Short Tau Inversion Recovery images were obtained using a 12 cm field of view as standard.


RESULTS
There were 342 abnormal scans (56%) and 269 (44%) normal scans. Of the abnormal scans, 80% showed acute bony injuries, 8% showed acute soft tissue injuries and 12% showed incidental pathology.


CONCLUSIONS
MRI is a useful and effective tool in the diagnosis of radiologically occult wrist injuries. It is feasible to do MRI scans in a timely manner in a district general hospital.
Khalid
Mohamed
M
Nevill Hall Hospital, Abergavenny, UK. Khalidbones@hotmail.com
Jummani
Ziadanesh R
ZR
Kanagaraj
Kaliannan
K
Hussain
Amir
A
Robinson
David
D
Walker
Russell
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D050723:Fractures, Bone / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D021361:Scaphoid Bone / Q000293:injuries*; D055815:Young Adult