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Scaphoid fracture (MRI)

Case contributed by Manar Alaa El Din osman
Diagnosis almost certain


Falling onto the hand.

Patient Data

Age: 35 years
Gender: Male

A fracture line traverses the scaphoid waist with partial collapse at its proximal pole, subchondral tiny cystic lesions, and surrounding altered signal being of bright STIR and low T1/T2 signals indicating likely avascular necrosis of scaphoid.

Case Discussion

Scaphoid fractures usually occur after falling onto the outstretched hand. They affect the waist of the scaphoid more commonly than the distal and proximal poles. Early diagnosis and management can prevent late complications such as avascular necrosis. Cast immobilization is preferred in acute settings for non-displaced fractures. For displaced fractures, surgery is often considered. For patients presenting with avascular necrosis of the scaphoid, surgery is often considered. It is also important to consider age, occupation, medical co-morbidities and smoking status to decide between conservative vs surgical options.

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