[Use of MRI for diagnosing scaphoid fracture].
BACKGROUND
Oslo accident and emergency clinic (Oslo skadelegevakt) treats most scaphoid fractures in Oslo. The objectives of this study were to assess the usefulness of MRI in diagnosing such fractures and to determine the number of scaphoid fractures treated at our clinic, the number of patients treated with a scaphoid cast without having a fracture, the proportion of these fractures diagnosed with conventional radiographs and that diagnosed with MRI in a given period.


METHODS
The article is based on a review of medical records from all patients who had taken scaphoid radiographs at Oslo accident and emergency clinic in the period 1 July 2005 - 30 June 2006.


RESULTS
532 patients had their forearm immobilized in a scaphoid cast because of a clinically suspected scaphoid fracture or a diagnosed fracture. 154 of these (29 %) had a scaphoid fracture; 88 (57 %) of them were diagnosed by using conventional radiographs at the first consultation, 8 (5 %) were diagnosed at a second radiographic examination (after 1 to 2 weeks) and 58 (38 %) by use of MRI at a control visit. At the control visit 228 patients were referred to MRI; 91 (40 %) of them had a fracture (58 [25 %] had a scaphoid fracture and 33 [14 %] had other fractures). In children 10 - 14 years of age MRI was used to diagnose 22 of 26 scaphoid fractures.


CONCLUSIONS
Three of four patients treated with a scaphoid cast due to a suspected scaphoid fracture had no fracture. Early MRI can reduce the time of immobilization for patients without fracture. Use of MRI to diagnose scaphoid fractures probably leads to treatment of some fractures that would heal without immobilization, especially in children who constituted the group most often diagnosed by MRI.
Glad
Trygve Holm
TH
Ortopedisk avdeling, Sørlandet sykehus Arendal, Serviceboks 605, 4809 Arendal, Norway. trygve.holm.glad@sshf.no
Melhuus
Knut
K
Svenningsen
Svein
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004636:Emergency Service, Hospital; D005592:Fracture Fixation; D050723:Fractures, Bone / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D011859:Radiography; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries*; D055815:Young Adult