Scaphoid avascular necrosis (contrast-enhanced MRI)
Chronic wrist pain post injury 6 months prior.
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Non-united scaphoid waist fracture. Within the proximal fracture fragment adjacent to the fracture line is a T1 hypointense, T2 hyperintense region bordered by a low T2 rim that does not enhance. The remainder of the proximal fracture fragment shows a similar enhancement to the distal fracture fragment.
Comment: Approximately 25% avascular necrosis of the scaphoid proximal fracture fragment.
Contrast-enhanced MRI has been shown to correlate well with intra-operative vascularity of the scaphoid, however, this appears independent from the success of scaphoid non-union surgery.
- Schneider K. Rancy, Morgan M. Swanstrom, Edward F. DiCarlo, Darryl B. Sneag, Steve K. Lee, Scott W. Wolfe, Scaphoid Nonunion Consortium. Success of scaphoid nonunion surgery is independent of proximal pole vascularity:. (2017) Journal of Hand Surgery (European Volume). 43 (1): 32-40. doi:10.1177/1753193417732003 - Pubmed
- K. Megerle, H. Worg, G. Christopoulos, R. Schmitt, H. Krimmer. Gadolinium-enhanced preoperative MRI scans as a prognostic parameter in scaphoid nonunion:. (2010) Journal of Hand Surgery (European Volume). 36 (1): 23-8. doi:10.1177/1753193410375776 - Pubmed