FIGURE 2. Axial T2-weighted, fat-saturated magnetic resonance images of the right shoulder demonstrating a posterior labral tear (white arrow) with a large multiloculated paralabral cyst (orange arrows), which extended into the spinoglenoid (left) and suprascapular (right) notches, likely resulting in significant compression of the suprascapular nerve.journal of orthopaedic & sports physical therapy | volume 43 | number 7 | july 2013 | 511

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Context:The scaphoid is the most commonly fractured bone in the wrist and can often be difficult to treat and manage, making healing of this fracture problematic.Evidence Acquisition:A search of the entire PubMed (MEDLINE) database using the terms scaphoid fracture management and scaphoid fracture evaluation returned several relevant anatomic and imaging references.Results:Wrist fractures most commonly occur in the scaphoid, which is implicated approximately 60% of the time. The most common mechanism of injury leading to a scaphoid fracture is a fall on an outstretched hand (FOOSH), causing a hyperextension force on the wrist. The following 2 cases, which occurred within 3 months of each other, highlight the difficulty of managing patients with possible scaphoid fractures. Neither patient had a typical FOOSH-related mechanism of injury, and neither was initially tender over the scaphoid.Conclusion:Differential diagnoses should include a scaphoid fracture with any hyperextension traumatic injury (FOOSH or non-FOOSH), even in the absence of scaphoid tenderness and when initial radiographic findings are normal.

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