title: Role of MRI in the diagnosis of clinically suspected scaphoid fracture: analysis of 611 consecutive cases and literature review.
abstract: 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.
authors.affiliation: Nevill Hall Hospital, Abergavenny, UK. Khalidbones@hotmail.com
authors.forename: Mohamed
authors.initials: M
authors.lastname: Khalid
authors.forename: Ziadanesh R
authors.initials: ZR
authors.lastname: Jummani
authors.forename: Kaliannan
authors.initials: K
authors.lastname: Kanagaraj
authors.forename: Amir
authors.initials: A
authors.lastname: Hussain
authors.forename: David
authors.initials: D
authors.lastname: Robinson
authors.forename: Russell
authors.initials: R
authors.lastname: Walker
mesh_terms: 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