A male asked:
Question about diagnosis/misdiagnosis of scaphoid fracture. several months ago a box fell on my hand near the base of my thumb, i was concerned that something may have been broken or fractured, but i had mri which should bones were intact. how likely tha
2 doctor answers • 3 doctors weighed in
Dr. Jeffrey Wintanswered
Hand Surgery 37 years experience
This : This has nothing to do with training, experience or expertise. Some fractures just don't show up despite proper good standard assessment, but the percentages are small. The radiologist who read the study as negative also is trained to do so. To get an idea of the complexity of this question see the links below
an MRI that is read as negative for scaphoid fracture rules out a fracture most of the time.
There can be false negatives and false positives. A MRI will detect variations in the bones trabecular pattern ( inside the bone) often associated with negative x-rays. If anything inexperience in reading MRI can lead to over diagnosing a fracture by mri.
Other tests include a ct scan, which is better for cortical ( outside) disruption and a bone scan which is less specific
a contused or bruised joint near the base of the thumb especially if there is even a touch of mild arthritis can often take time to feel better
a good way to assess persistent pain several months after injury is to be reevaluated and get new plain x-rays including scaphoid views and be assessed for things other than a scaphoid fracture that can still give wrist pain.
Created for people with ongoing healthcare needs but benefits everyone.
5.3k viewsReviewed >2 years ago
Dr. Francisco Schwartz-Fernandesanswered
Hand Surgery 28 years experience
In : In addition to the previous answer-bone scan and us can also help in diagnosis scaphoid fractures, in acute situations.
Created for people with ongoing healthcare needs but benefits everyone.
5.3k viewsReviewed >2 years ago
Last updated Dec 7, 2017
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