Skip to main content
SpringerLink
Log in

The role of MR imaging in scaphoid disorders

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The scaphoid bone of the wrist is one of the most commonly fractured bones in the body. Due to its importance in the biomechanics and functionality of the wrist, it is important to depict and characterize the type of injury. Plain radiographs and scintigraphy may fail to disclose the type and severity of the injury. In patients with normal initial plain radiographs, MR imaging can discriminate occult fractures from bone bruises and may also demonstrate ligamentous disruption. MR imaging can also discriminate the proximal pole viability versus avascular necrosis secondary to previous fracture, which is important for treatment planning. Treatment of non-united fractures with vascularized grafts can be evaluated with contrast-enhanced MR imaging. Idiopathic osteonecrosis or Preiser’s disease was originally described after trauma. The non-traumatic disorders of the scaphoid include post-traumatic osteoarthritis, inflammatory bone marrow edema in patients with rheumatoid arthritis, and osteomyelitis. MR imaging is helpful in all the above disorders to demonstrate early bone marrow edema, cartilage degeneration and associated subchondral marrow changes. The most commonly found tumors in the scaphoid are usually benign and include enchondroma, osteoblastoma and osteoid osteoma. MR imaging is not mandatory for the initial diagnosis, which should be based on plain X-ray findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16

Similar content being viewed by others

References

  1. Amadio PC (1992) Scaphoid fractures. Orthop Clin North Am 1:7–17

    Google Scholar 

  2. Berger RA (2001) The anatomy of the scaphoid. Hand Clin 17:525–532

    PubMed  CAS  Google Scholar 

  3. Linn MR, Mann FA, Gilula LA (1990) Imaging the symptomatic wrist. Orthop Clin North Am 21:515–543

    PubMed  CAS  Google Scholar 

  4. Goldfarb CA, Yin Y, Gilula LA, Fisher AJ, Boyer MI (2001) Wrist fractures: What the clinician wants to know. Radiology 219:11–28

    PubMed  CAS  Google Scholar 

  5. Munk PL, Lee MJ, Logan PM et al (1997) Scaphoid bone waist fractures, acute and chronic: imaging with different techniques. AJR Am J Roentgenol 168:779–786

    PubMed  CAS  Google Scholar 

  6. Low G, Raby N (2005) Can follow-up radiography for acute scaphoid fracture still be considered a valid investigation? Clin Radiol 60:1106–1110

    Article  PubMed  CAS  Google Scholar 

  7. Roolker W, Tiel-van Buul MM, Ritt MJ, Verbeeten B Jr, Griffioen FM, Broekhuizen AH (1997) Experimental evaluation of scaphoid X-series, carpal box radiographs, planar tomography, computed tomography, and magnetic resonance imaging in the diagnosis of scaphoid fracture. J Trauma 42:247–253

    PubMed  CAS  Google Scholar 

  8. Hauger O, Bonnefoy O, Moinard M, Bersani D, Diard F (2002) Occult fractures of the waist of the scaphoid: early diagnosis by high-spatial-resolution sonography. AJR Am J Roentgenol 178:1239–1245

    PubMed  Google Scholar 

  9. Breederveld RS, Tuinebreijer WE (2004) Investigation of computed tomographic scan concurrent criterion validity in doubtful scaphoid fracture of the wrist. J Trauma 57:851–854

    PubMed  CAS  Google Scholar 

  10. Groves AM, Cheow H, Balan K, Courtney H, Bearcroft P, Dixon A (2005) 16-MDCT in the detection of occult wrist fractures: a comparison with skeletal scintigraphy. AJR Am J Roentgenol 184:1470–1474

    PubMed  Google Scholar 

  11. Bellmore MC, Cummine JL, Crocker RF, Canseldine DB (1983) The role of bone scans in the assessment of prognosis of scaphoid fracture. Aust N Z J Surg 53:133–137

    PubMed  CAS  Google Scholar 

  12. Fowler C, Sullivan B, Williams LA, McCarthy G, Savage R, Palmer A (1998) A comparison of bone scintigraphy and MRI in the early diagnosis of the occult scaphoid waist fracture. Skeletal Radiol 27:683–687

    Article  PubMed  CAS  Google Scholar 

  13. Gabler C, Kukla C, Breitenseher M, Trattnig S, Mittlboeck M, Vecsei V (1996) Magnetic resonance imaging of occult scaphoid fractures. J Trauma 41:73–76

    Google Scholar 

  14. Cook PA, Yu JS, Wiand W, Cook AJ II, Coleman CR, Cook AJ (1997) Suspected scaphoid fractures in skeletally immature patients: application of MRI. J Comput Assist Tomogr 21:511–515

    Article  PubMed  CAS  Google Scholar 

  15. Brydie A, Raby N (2003) Early MRI in the management of clinical scaphoid fracture. Br J Radiol 76:296–300

    Article  PubMed  CAS  Google Scholar 

  16. Hunter JC, Escobedo EM, Wilson AJ, Hanel DP, Zink-Brody GC, Mann FA (1997) MR imaging of clinically suspected scaphoid fractures. AJR Am J Roentgenol 168:1287–1293

    PubMed  CAS  Google Scholar 

  17. Breitenseher MJ, Metz VM, Gilula LA et al (1997) Radiographically occult scaphoid fractures: value of MR imaging in detection. Radiology 203:245–250

    PubMed  CAS  Google Scholar 

  18. Bhat M, McCarthy M, Davis TR, Oni JA, Dawson S (2004) MRI and plain radiography in the assessment of displaced fractures of the waist of the carpal scaphoid. J Bone Joint Surg [Br] 86:705–713

    Article  CAS  Google Scholar 

  19. Kumar S, O’Connor A, Despois M, Galloway H (2005) Use of early magnetic resonance imaging in the diagnosis of occult scaphoid fractures: the CAST study (Canberra Area Scaphoid Trial). N Z Med J 118:U1296

    PubMed  Google Scholar 

  20. Rangger C, Kathrein A, Freund MC, Klestil T, Kreczy A (1998) Bone bruise of the knee: histology and cryosections in 5 cases. Acta Orthop Scand 69:291–294

    PubMed  CAS  Google Scholar 

  21. Dailiana ZH, Zachos V, Varitimidis S, Papanagiotou P, Karantanas A, Malizos KN (2004) Scaphoid nonunions treated with vascularised bone grafts: MRI assessment. Eur J Radiol 50:217–224

    Article  PubMed  CAS  Google Scholar 

  22. Mandalia V, Fogg AJ, Chari R, Murray J, Beale A, Henson JH (2005) Bone bruising of the knee. Clin Rad 60:627–636

    Article  CAS  Google Scholar 

  23. Kapelov SR, Teresi LM, Bradley WG et al (1993) Bone contusions of the knee: increased lesion detection with fast spin-echo MR imaging with spectroscopic fat saturation. Radiology 189:901–904

    PubMed  CAS  Google Scholar 

  24. Dorsay TA, Major NM, Helms CA (2001) Cost-effectiveness of immediate MR imaging versus traditional follow-up for revealing radiographically occult scaphoid fractures. AJR Am J Roentgenol 177:1257–1263

    PubMed  CAS  Google Scholar 

  25. Blevens AD, Light TR, Jablonsky WS, Smith DG, Patwardhan AG, Guay ME, Woo TS (1989) Radiocarpal articular contact characteristics with scaphoid instability. J Hand Surg [Am] 14:781–790

    Article  CAS  Google Scholar 

  26. Werner FW, Short WH, Green JK (2005) Changes in patterns of scaphoid and lunate motion during functional arcs of wrist motion induced by ligament division. J Hand Surg [Am] 30:1156–1160

    Article  Google Scholar 

  27. Walsh JJ, Berger RA, Cooney WP (2002) Current status of scapholunate interosseous ligament injuries. J Am Acad Orthop Surg 10:32–42

    PubMed  Google Scholar 

  28. Haims AH, Schweitzer ME, Morrison WB et al (2003) Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging. Radiology 227:701–707

    Article  PubMed  Google Scholar 

  29. Schmid MR, Schertler T, Pfirrmann CW et al (2005) Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging. Radiology 237:1008–1013

    Article  PubMed  Google Scholar 

  30. Barton NJ (1992) Twenty questions about scaphoid fractures. J Hand Surg [Br] 17B:289–310

    Article  Google Scholar 

  31. Barton NJ (1996) Apparent and partial non-union of the scaphoid. J Hand Surg [Br] 21:496–500

    Article  CAS  Google Scholar 

  32. Dias JJ, Taylor M, Thompson J, Brenkel IJ, Gregg PJ (1988) Radiographic signs of union of scaphoid fractures. An analysis of inter-observer agreement and reproducibility. J Bone Joint Surg [Br] 70:299–301

    CAS  Google Scholar 

  33. McNally EG, Goodman R, Burge P (2000) The role of MRI in the assessment of scaphoid fracture healing: a pilot study. Eur Radiol 10:1926–1928

    Article  PubMed  CAS  Google Scholar 

  34. Imaeda T, Nakamura R, Miura T, Makino N (1992) Magnetic resonance imaging in scaphoid fractures. J Hand Surg [Br] 17:20–27

    Article  CAS  Google Scholar 

  35. Perlik PC, Guilford WB (1991) Magnetic resonance imaging to assess vascularity of scaphoid nonunions. J Hand Surg [Am] 16A(3):479–484

    Google Scholar 

  36. Dias JJ, Hui AC, Lamont AC (1994) Real time ultrasonography in the assessment of movement at the site of a scaphoid fracture non-union. J Hand Surg [Br] 19:498–504

    Article  CAS  Google Scholar 

  37. Schuind F, Haentjens P, van Innis F, Vander Maren C, Garcia-Elias M, Senwald G (1999) Prognostic factors in the treatment of carpal scaphoid nonunion. J Hand Surg [Am] 24A:761–776

    Article  Google Scholar 

  38. Green DP (1985) The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion. J Hand Surg [Am] 10:597–605

    CAS  Google Scholar 

  39. Trumble TE (1990) Avascular necrosis after scaphoid fracture: a correlation of magnetic resonance imaging and histology. J Hand Surg Am 15:557–564

    Article  PubMed  CAS  Google Scholar 

  40. Sakuma M, Nakamura R, Imaeda T (1995) Analysis of proximal fragment sclerosis and surgical outcome of scaphoid non-union by magnetic resonance imaging. J Hand Surg [Br] 20B:201–205

    Article  Google Scholar 

  41. Morgan WJ, Breen TF, Coumas JM, Schulz LA (1997) Role of magnetic resonance imaging in assessing factors affecting healing in scaphoid nonunions. Clin Orthop 336:240–246

    Article  PubMed  Google Scholar 

  42. Cerezal L, Abascal F, Canga A, Garcia-Valtuille R, Bustamante M, del Pinal F (2000) Usefulness of gadolinium-enhanced MR imaging in the evaluation of the vascularity of scaphoid nonunions. AJR Am J Roentgenol 174:141–149

    PubMed  CAS  Google Scholar 

  43. Dawson JS, Martel AL, Davis TR (2001) Scaphoid blood flow and acute fracture healing. A dynamic MRI study with enhancement with gadolinium. J Bone Joint Surg Br 83:809–814

    Article  PubMed  CAS  Google Scholar 

  44. Inoue G, Sakuma M (1996) The natural history of scaphoid non-union. Radiographical and clinical analysis in 102 cases. Arch Orthop Trauma Surg 115:1–4

    Article  PubMed  CAS  Google Scholar 

  45. Buchler U, Nagy L (1995) The issue of vascularity in fractures and non-union of the scaphoid. J Hand Surg [Br] 20-B:726–735

    Article  Google Scholar 

  46. Varitimidis SE, Zachos V, Dailiana ZH, Malizos KN (2006) Spontaneous absorption of proximal scaphoid: a case report of succesful treatment with costo-osteochondral autograft. Am J Orthop 35:329–332

    PubMed  Google Scholar 

  47. Anderson SE, Steinbach LS, TscheringVogel D, Martin M, Nagy L (2005) MR imaging of avascular scaphoid nonunion before and after vascularized bone grafting. Skeletal Radiol 34:314–320

    Article  PubMed  Google Scholar 

  48. Munk PL, Lee MJ, Janzen DL et al (1998) Gadolinium-enhanced dynamic MRI of the fractured carpal scaphoid: preliminary results. Australas Radiol 42:10–15

    PubMed  CAS  Google Scholar 

  49. Kulkarni RW, Wollstein R, Tayar R, Citron N (1999) Patterns of healing of scaphoid fractures: the importance of vascularity. J Bone Joint Surg Br 81:85–90

    Article  PubMed  CAS  Google Scholar 

  50. Desser TS, McCarthy S, Trumble T (1990) Scaphoid fractures and Kienbock’s disease of the lunate: MR imaging with histopathologic correlation. Magn Reson Imaging 8:357–361

    Article  PubMed  CAS  Google Scholar 

  51. Singh AK, Davis TRC, Dawson JS, Oni JA, Downing ND (2004) Cadolinium enhanced MR assessment of proximal fragment vascularity in nonunions after scaphoid fracture: does it predict the outcome of reconstructive surgery? J Hand Surg [Br] 29B:444–448

    Article  Google Scholar 

  52. Malizos KN, Dailiana ZH, Kirou M, Vragalas V, Xenakis TA, Soucacos PN (2001) Longstanding nonunions of scaphoid fractures with bone loss: successful reconstruction with vascularized bone grafts. J Hand Surg [Br] 26:330–334

    Article  CAS  Google Scholar 

  53. Dailiana Z, Malizos KN, Urbaniak JR (2005) Vascularized periosteal flaps of distal forearm and hand. J Trauma 58:76–82

    PubMed  Google Scholar 

  54. Ganapathi M, Joseph G, Savage R, Jones AR, Timms B, Lyons K (2002) MRI susceptibility artefacts related to scaphoid screws: the effect of screw type, screw orientation and imaging parameters. J Hand Surg Br 27:165–170

    Article  PubMed  CAS  Google Scholar 

  55. Watson HK, Ryu J (1986) Evolution of arthritis of the wrist. Clin Orthop Relat Res 202:57–67

    PubMed  Google Scholar 

  56. Ruby LK, Stinson J, Belsky MR (1985) The natural history of scaphoid non-union. A review of fifty-five cases. J Bone Joint Surg 67-A:428–432

    Google Scholar 

  57. Lindström G, Nyström A (1992) Natural history of scaphoid non-union, with special reference to “asymptomatic” cases. J Hand Surg 17–B:697–700

    Google Scholar 

  58. Takka S, Poyraz A (2002) Enchondroma of the scaphoid bone. Arch Orthop Trauma Surg 122:369–370

    Article  PubMed  Google Scholar 

  59. Malizos KN, Gelalis ID, Ioachim EE, Soucacos PN (1998) Pathologic fracture of the scaphoid due to enchondroma: treatment with vascularised bone grafting. Report of a case. J Hand Surg [Am] 23:334–337

    Article  CAS  Google Scholar 

  60. Kalainov DM, Cohen MS, Hendrix RW, Sweet S, Culp RW, Osterman AL (2003) Preiser’s disease: identification of two patterns. J Hand Surg 28A:767–778

    Google Scholar 

  61. McQueen FM, Benton N, Crabbe J et al (2001) What is the fate of erosions in early rheumatoid arthritis? Tracking individual lesions using x-rays and magnetic resonance imaging over the first 2 years of disease. Ann Rheum Dis 60:859–868

    PubMed  CAS  Google Scholar 

  62. McQueen F, Stewart N, Crabbe J et al (1998) Magnetic resonance imaging of the wrist in early rheumatoid arthritis reveals a high prevalence of erosions at 4 months after symptom onset. Ann Rheum Dis 57:350–356

    Article  PubMed  CAS  Google Scholar 

  63. Dubrana F, Le Nen D, Hu W, Poureyron Y, Pazart F, Lefevre C (1999) Bilateral bipartite carpal scaphoid bone: a congenital disease or unrecognized pseudarthrosis? Discussion a propos of a clinical case. Rev Chir Orthop Reparatrice Appar Mot 85:503–506

    PubMed  CAS  Google Scholar 

  64. De Smet L (2005) Unilateral congenital absence of the lunate and scaphoid. Genet Couns 16:413–415

    PubMed  Google Scholar 

  65. Mavi A, Cagman B, Ozkur A, Bayram M, Gumusburun E (2002) The congenital absence of the radius, scaphoid, trapezium, thumb and hypoplasia of the lunate. Saudi Med J 23:1005–1007

    PubMed  Google Scholar 

  66. Patankar H (1998) Bilateral congenital aplasia of the scaphoid. J Hand Surg [Br] 23:817–919

    Article  CAS  Google Scholar 

  67. Barnes CL, Frazier GT, Hixson ML (1992) Bilateral congenital fusion of the scaphoid and trapezium in identical twins. Orthopedics 15:739–741

    PubMed  CAS  Google Scholar 

  68. Boya H, Ozcan O, Arac S, Tandogan R (2005) Incomplete scapholunate and trapeziotrapezoid coalitions with an accessory carpal bone. J Orthop Sci 10:99–102

    Article  PubMed  Google Scholar 

  69. Baek GH, Chung MS (2002) Methicillin-resistant Staphylococcus aureus osteomyelitis of the scaphoid from a catheter in the radial artery. J Bone Joint Surg [Br] 84:273–274

    Article  Google Scholar 

  70. Beltran J, McGhee RB, Shaffer PB et al (1988) Experimental infections of the musculoskeletal system: Evaluation with MR imaging and Tc-99 MDP and Ga-67 scintigraphy. Radiology 167:167–172

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Medical School, University of Crete, Heraklion, Greece

    Apostolos Karantanas

  2. Department of Orthopedic Surgery, School of Health Sciences, University of Thessaly, Larissa, Greece

    Zoe Dailiana & Konstantinos Malizos

  3. Department of Radiology, University Hospital, Stavrakia, Heraklion, 711 10, Greece

    Apostolos Karantanas

Authors
  1. Apostolos Karantanas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zoe Dailiana
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Konstantinos Malizos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Apostolos Karantanas.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Karantanas, A., Dailiana, Z. & Malizos, K. The role of MR imaging in scaphoid disorders. Eur Radiol 17, 2860–2871 (2007). https://doi.org/10.1007/s00330-007-0624-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-007-0624-z

Keywords

Search

Navigation