Skip to main content
PMC home page
Archives of Emergency Medicine logoLink to Archives of Emergency Medicine
. 1986 Dec;3(4):235–242. doi: 10.1136/emj.3.4.235

Bone scintigraphy in the management of X-ray-negative potential scaphoid fractures.

A W Wilson, M H Kurer, J L Peggington, D S Grant, C C Kirk
PMCID: PMC1285374  PMID: 3801112

Abstract

One hundred and eleven patients with signs and symptoms of carpal scaphoid injury, but with no fracture visible on X-ray, underwent bone scintigraphy of the wrists. The first 42 patients were re-X-rayed 10 days after injury: bone scanning had identified all fractures confirmed on this X-ray; there were no false negative bone scans. Sixty-seven patients (60%) did not have increased focal uptake over the scaphoid or distal radius, and were mobilised immediately. None of these had a fracture at follow up. Twenty-nine patients with increased uptake over the scaphoid area (26%) remained in plaster of Paris for 6 weeks. All of these had clinical signs of a scaphoid injury. Bone scanning is a practical investigation for all X-ray-negative potential scaphoid injuries, and is acceptable to patient and clinician. In the presence of a normal scan, the practice of re-X-raying patients 10 days after injury may be abandoned.

Full text

PDF

Images in this article

237Fig. 2
on p.237
238Fig. 3
on p.238
239Fig. 4
on p.239
239Fig. 5
on p.239

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Batillas J., Vasilas A., Pizzi W. F., Gokcebay T. Bone scanning in the detection of occult fractures. J Trauma. 1981 Jul;21(7):564–569. doi: 10.1097/00005373-198107000-00011. [DOI] [PubMed] [Google Scholar]
  2. Bedford A. F., Glasgow M. M., Wilson J. N. Ultrasonic assessment of fractures and its use in the diagnosis of the suspected scaphoid fracture. Injury. 1982 Sep;14(2):180–182. doi: 10.1016/0020-1383(82)90056-0. [DOI] [PubMed] [Google Scholar]
  3. Dunn A. W. Fractures and dislocations of the carpus. Surg Clin North Am. 1972 Dec;52(6):1513–1538. doi: 10.1016/s0039-6109(16)39895-4. [DOI] [PubMed] [Google Scholar]
  4. Fordham E. W., Ramachandran P. C. Radionuclide imaging of osseous trauma. Semin Nucl Med. 1974 Oct;4(4):411–429. doi: 10.1016/s0001-2998(74)80032-2. [DOI] [PubMed] [Google Scholar]
  5. Ganel A., Engel J., Oster Z., Farine I. Bone scanning in the assessment of fractures of the scaphoid. J Hand Surg Am. 1979 Nov;4(6):540–543. doi: 10.1016/s0363-5023(79)80006-4. [DOI] [PubMed] [Google Scholar]
  6. Mack G. R., Bosse M. J., Gelberman R. H., Yu E. The natural history of scaphoid non-union. J Bone Joint Surg Am. 1984 Apr;66(4):504–509. [PubMed] [Google Scholar]
  7. Marty R., Denney J. D., McKamey M. R., Rowley M. J. Bone trauma and related benign disease: assessment by bone scanning. Semin Nucl Med. 1976 Jan;6(1):107–120. doi: 10.1016/s0001-2998(76)80040-2. [DOI] [PubMed] [Google Scholar]
  8. Matin P. The appearance of bone scans following fractures, including immediate and long-term studies. J Nucl Med. 1979 Dec;20(12):1227–1231. [PubMed] [Google Scholar]
  9. Nielsen P. T., Hedeboe J., Thommesen P. Bone scintigraphy in the evaluation of fracture of the carpal scaphoid bone. Acta Orthop Scand. 1983 Apr;54(2):303–306. doi: 10.3109/17453678308996574. [DOI] [PubMed] [Google Scholar]
  10. O'Carroll P. F., Doyle J., Duffy G. Radiography and scintigraphy in the diagnosis of carpal scaphoid fractures. Ir J Med Sci. 1982 Jul;151(7):211–213. doi: 10.1007/BF02940182. [DOI] [PubMed] [Google Scholar]
  11. Onuba O., Ireland J. Two cases of non-union of fractures of the scaphoid in children. Injury. 1983 Sep;15(2):109–112. doi: 10.1016/0020-1383(83)90036-0. [DOI] [PubMed] [Google Scholar]
  12. RUSSE O. Fracture of the carpal navicular. Diagnosis, non-operative treatment, and operative treatment. J Bone Joint Surg Am. 1960 Jul;42-A:759–768. [PubMed] [Google Scholar]
  13. Rolfe E. B., Garvie N. W., Khan M. A., Ackery D. M. Isotope bone imaging in suspected scaphoid trauma. Br J Radiol. 1981 Sep;54(645):762–767. doi: 10.1259/0007-1285-54-645-762. [DOI] [PubMed] [Google Scholar]
  14. Rosenthall L., Hill R. O., Chuang S. Observation of the use of 99mTc-phosphate imaging in peripheral bone trauma. Radiology. 1976 Jun;119(3):637–637. doi: 10.1148/119.3.637. [DOI] [PubMed] [Google Scholar]
  15. Stordahl A., Schjøth A., Woxholt G., Fjermeros H. Bone scanning of fractures of the scaphoid. J Hand Surg Br. 1984 Jun;9(2):189–190. [PubMed] [Google Scholar]
  16. Sy W. M., Bay R., Camera A. Hand images: normal and abnormal. J Nucl Med. 1977 May;18(5):419–424. [PubMed] [Google Scholar]

Articles from Archives of Emergency Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES