MAGNETIC-RESONANCE-IMAGING OF OCCULT SCAPHOID FRACTURES

Occult fractures of the scaphoid bone occur frequently and may lead to nonunions, In a prospective blind study, we performed magnetic resona nce imaging (MRI) examinations on 32 patients who had sustained a wris t injury and in whom a scaphoid fracture was clinically suspected, but could not be confirmed on the original set of two routine and four sc aphoid view radiographs, The MRI examinations were performed an averag e time of 2.8 days after the trauma, This prospective study proved tha t MRI is able to diagnose occult scaphoid fractures without delay and without the use of radioactive diagnostic means. Sensitivity and speci ficity of MRI were 100%, This conventional method could save $7,200 (U S) per 100,000 inhabitants in providing an immediate and correct diagn osis and avoiding unnecessary cast immobilization, Additional injuries that may be misdiagnosed by conventional radiographs are also detecte d with a specificity and sensitivity of 100%.