MRI is a useful and effective tool in the diagnosis of radiologically occult wrist injuries. It is feasible to do MRI scans in a timely manner in a district general hospital.

No abstract

Background: With the increasing use of magnetic resonance imaging (MRI) for the diagnosis of occult wrist injuries, microfracturing or bruising of scaphoid is being recognised as a distinct entity. Aims: The aim of our study was to study the clinical significance of scaphoid microfractures. Materials and methods: From our database of 611 MRI scans for occult wrist injuries from January 2003 to November 2005, a total of 48 subjects (33 males and 15 females) with scaphoid microfractures were identified. Average age was 18.7 years (SD 8.9, range 9-41). They were all treated symptomatically with a futura splint. Each of them was matched for age and gender with a control with normal MRI from our database. Case notes and X-rays were reviewed. A telephone interview using the Harvard pain scale and functional component of modified Mayo wrist score was carried out for the cases and controls (best score 8 and worst score 32) at least 6 months following the injury. Statistical significance was calculated using paired student t test. Results: At a minimum follow-up of 6 months (range 6 months to 3 years), there was no statistically significant difference between the cases and controls with respect to symptoms [eight out of 48 (16.7%) versus nine out of 48 (18.75%)], severity of pain (mean Harvard pain score 1.36 versus 1.34), or functional status (functional component of modified Mayo wrist score 8.67 versus 8). Conclusion: Scaphoid microfractures occur predominantly in the young and behave in a benign fashion clinically. There does not appear to be any residual problems after these injuries. Long-term prospective studies are, however, necessary to determine the natural history of this injury.