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False negative 16 detector multislice CT for scaphoid fracture

Departments of ¹ Radiology and ² Nuclear Medicine, Addenbrooke's Hospital and the University of Cambridge, Hills Road, Cambridge CB2 2QQ, UK

View larger version (99K): [in a new window]   Figure 1. (a) Dorsopalmar radiograph of the left wrist on the day of injury with no evidence of fracture. (b) Dorsopalmar radiograph of the left wrist 10 days post trauma. No evidence of fracture is seen.

View larger version (96K): [in a new window]   Figure 2. Local view of the hand from a 99Tcm-methylene diphosphonate labelled bone scintigram showing increased tracer uptake in the region of the left scaphoid.

View larger version (130K): [in a new window]   Figure 3. Coronal reconstruction from a 16-detector multidetector CT of the left wrist 10 days post injury. The image was obtained using the 0.75 mm detectors and reconstructed in 0.5 mm intervals using a hard tissue algorithm. No fracture is identified.

View larger version (71K): [in a new window]   Figure 4. (a) T1 weighted coronal MRI of the left wrist performed 13 days post trauma showing reduced signal in scaphoid. (b) Fat saturated T2 weighted coronal MRI of the left wrist performed 13 days post trauma showing high signal in the scaphoid. There is a suggestion of a fracture line in the proximal one third.

View larger version (182K): [in a new window]   Figure 5. Dorsopalmar radiograph of the left wrist 6 weeks post injury. A fracture is identified affecting the proximal pole of the scaphoid.