Diagnosis of Occult Carpal Scaphoid Fracture: A Comparison of Magnetic Resonance Imaging and Computed Tomography Techniques

Abstract

We investigated 52 consecutive patients (53 wrists) with suspected scaphoid fracture using MRI (0.2 T) within 7 days after the injury. We performed two sequences for the wrist: (1) coronal T1-weighted spin-echo and (2) T2-weighted turbo spin-echo. We also performed four sequences specific for the scaphoid with the plane parallel to the longitudinal axis of the scaphoid: (1) coronal T1-weighted, (2) coronal T2-weighted, (3) sagittal T1-weighted, and (4) sagittal T2-weighted images. In these projections, only one section is enough to cover the scaphoid fracture that definitely eased the diagnosis. In 18 (33%) wrists, the scaphoid fracture was detected on MRI. Computed tomograms (CT) were also taken with angled sagittal and coronal projections in 16 of the 18 wrists in which the scaphoid fracture was detected on MRI. CT revealed ten nondisplaced fractures, three displaced fractures, and three occult fractures. Bone contusion was found in no patients. MRI is a useful modality as a screening for occult scaphoid fracture.