Diagnosis of Scaphoid Fractures and Displacement:
Reliability of CT versus MRI
A Prospective Study

The scaphoid bone is the carpal bone most commonly fractured in wrist trauma.
This type of fracture is typical in young male population sustaining trauma
during sports or heavy labor duties.
Early fracture detection and diagnosis of suspected scaphoid fractures is of
great importance since the vascularity of this bone is a jeopardizing factor in
fracture healing. Early detection and adequate treatment can provide
predictable and satisfactory rates of healing. In contrast, delay of diagnosis
and failure to recognize displacement are important risk factors for non-union
of scaphoid wrist fractures. Fractures that are not displaced are considered by
most as stable; in addition several studies have demonstrated predictable rates
of healing with conservative treatment for this type of fractures. Conversely,
displaced fractures are recognized as instable, with a significant risk of
non-union if not treated surgically.

This prospective study evaluates the intra- and inter-observer variability of
CT*the most common currently used modality of imaging diagnosis* versus
MRI-scans in the diagnosis of a scaphoid fracture and in the diagnosis of
displacement.

To assess the diagnostic performance characteriscs of CT versus MRI scanning
for suspected scaphoid fractures.

All patients that previously had wrist trauma and are clinically suspect for
having a scaphoid fracture will be prospectively included in our study when
they present within 24 hours after the injury. Twenty scans from non-fractured
patients, 20 non-displaced fractures and 10 displaced scaphoid fractures will
be the minimal sample size for this study. Scan must be obtained within 72
hours after presentation. All images will be organized in blinded packages and
then will be distributed online among member of the COAST study group to
determine the presence or absence of a scaphoid fracture and for assessment of
displacement.

Except for the two hours extension of their planned visit for the regular
clinical examination of their wrist, there is no further burden for the
patients.