Wrist – Scaphoid fracture

CASE HISTORY

• Evaluate for occult scaphoid fracture. Left wrist pain. 

TECHNICAL FACTORS

• Long- and short-axis fat- and water-weighted images were performed

KEY IMAGES

CASE FINDINGS

• Diffuse T2 and T1 signal abnormality involving the midportion of the scaphoid bone compatible with a hairline fracture midbody of the scaphoid. Cortical margins appear intact without evidence for 2-part injury. Normal overall morphology and outline of the scaphoid. No evidence for disruption of the scapholunate or lunotriquetral ligaments. Increased signal and thickening of the radioscaphoid ligament (radial collateral ligament) compatible with sprain.
• Distal radial and ulnar physes are normal.
• No other focal signal abnormality is noted.
• Normal appearance of the TFCC.
• Normal appearance of carpal tunnel flexor and extensor tendons.
• No ganglia noted.
• Intact musculature.
• Minimal synovitis noted at the scaphotrapezoid and scaphotrapezium articulations

CASE CONCLUSION

• Nondisplaced hairline transverse fracture of the midbody of the scaphoid without cortical disruption or evidence for 2-part type fracture
• Strain of the radioscaphoid (radial collateral) ligament and synovitis at triscaphe joints
• No other evidence for internal derangement