Skeletal Radiology

, Volume 27, Issue 12, pp 683–687 | Cite as

A comparison of bone scintigraphy and MRI in the early diagnosis of the occult scaphoid waist fracture

  • C. Fowler
  • B. Sullivan
  • L. A. Williams
  • G. McCarthy
  • R. Savage
  • A. Palmer

Abstract 

Objective. To determine the accuracy of MRI in the assessment of the radiographically occult scaphoid fracture. Design. This prospective study compared the sensitivity and specificity of MRI for detection of radiographically occult scaphoid fractures with bone scintigraphy (BS), the currently accepted imaging modality of choice. Consecutive patients with clinical signs of a scaphoid injury but no evidence of fracture on plain radiographs at presentation and after 7–10 days were evaluated by MRI and BS. All images were reported in masked fashion and the sensitivities and specificities of the imaging modalities determined. All patients with a scaphoid fracture demonstrated by MRI or BS were followed for at least a year after injury. Patients. Forty-three subjects (aged 12–74 years) had both MRI and BS carried out on average 19 days from the injury date. Results and conclusions. Six patients (14%) had scaphoid waist fractures. There were other bony injuries in a further six. In 40 patients there was agreement between the BS and MRI findings. In three cases there was discrepancy between the imaging modalities; in all three MRI was found to be the more sensitive and specific. MRI could become the investigation of choice for this injury.

Key words Scaphoid MRI Bone scintigraphy 

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Copyright information

© International Skeletal Society 1998

Authors and Affiliations

  • C. Fowler
    • 1
  • B. Sullivan
    • 2
  • L. A. Williams
    • 3
  • G. McCarthy
    • 4
  • R. Savage
    • 5
  • A. Palmer
    • 4
  1. 1.Department of Radiology, University Hospital of Wales, Cardiff CF4 4XW, UKGB
  2. 2.Department of Radiology, Royal Gwent Hospital, Newport, Gwent, UKGB
  3. 3.Department of Radiology, University Hospital of Wales, Cardiff, UKGB
  4. 4.Accident and Emergency, Royal Gwent Hospital, Newport, Gwent, UKGB
  5. 5.Department of Orthopaedics, Royal Gwent Hospital, Newport, Gwent, UKGB

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