Scaphoid fracture

Case contributed by Tim Luijkx
Diagnosis certain

Presentation

Fall on hand during football. Swelling of the wrist.

Patient Data

Age: 20
Gender: Male
x-ray

No fracture evident in the scaphoid.

mri

Bone marrow edema in scaphoid, lunate and triquetrum.

Hypointense line in the proximal pole of the scaphoid bone indicative of a fracture.

Well-corticated cyst in the lunate bone is incidentally noted.

Case Discussion

Scaphoid fractures can be notoriously hard to identify on x-ray, if possible at all.

MRI or CT is very useful to identify a fracture of the scaphoid.

MRI will show bone marrow edema on fluid-sensitive sequences and a hypointense line on T1.

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