Morbidity in adults with a normal limited scaphoid MRI: a retrospective cohort study and follow-up questionnaire

Bowles, Fiona; Keeton, Helen; Adlington, H; Cumberbatch, G L A; Markham, David W.

doi:10.1136/emermed-2012-201177

Cited by 1 publication

(1 citation statement)

References 22 publications

(13 reference statements)

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“…However, several patients with normal MRI had persistent symptoms. 96 A recent study using an examination protocol similar to the one described above 97 reported a small cost benefit for early MRI over conventional management with repeat radiography, but it also suggested a higher societal gain due to less unnecessary immobilization. Another recent study, adding limited MRI after normal follow-up radiographs 98 also showed similar costs to the standard protocol but reduced societal costs, as have other studies.…”

Section: Ultrasoundmentioning

confidence: 99%

Diagnosis of scaphoid fracture: optimal imaging techniques

Geijer¹

2013

RMI

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This review aims to provide an overview of modern imaging techniques for evaluation of scaphoid fracture, with emphasis on occult fractures and an outlook on the possible evolution of imaging; it also gives an overview of the pathologic and anatomic basis for selection of techniques. Displaced scaphoid fractures detected by wrist radiography, with or without special scaphoid views, pose no diagnostic problems. After wrist trauma with clinically suspected scaphoid fracture and normal scaphoid radiography, most patients will have no clinically important fracture. Between 5% and 19% of patients (on average 16% in meta-analyses) will, however, have an occult scaphoid fracture which, untreated, may lead to later, potentially devastating, complications. Follow-up imaging may be done with repeat radiography, tomosynthesis, computed tomography, magnetic resonance imaging (MRI), or bone scintigraphy. However, no method is perfect, and choice of imaging may be based on availability, cost, perceived accuracy, or personal preference. Generally, MRI and bone scintigraphy are regarded as the most sensitive modalities, but both are flawed by false positive results at various rates.

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Section: Ultrasoundmentioning

confidence: 99%