The role of Magnetic Resonance Imaging (MRI) in the diagnosis and management of patients with suspected scaphoid fractures

Lannie, Jack; St. John-Matthews, Janice

Abstract

Background: The scaphoid is the most commonly fractured carpal bone. Radiography has a low diagnostic accuracy and current methods of diagnosis result in many patients being unnecessarily immobilised for two weeks. The low sensitivity and specificity of radiography also means that fractures are missed, leading to avascular necrosis and secondary osteoarthritis. Clear protocols are absent throughout UK practice and this lack of clarity may be resulting in inappropriate diagnoses for many patients.


Aims: The primary aim of this project was to understand MRI’s role in diagnosing and managing patients with scaphoid fractures. Further objectives to this project were to compare MRI to other imaging modalities to identify the most appropriate method, to see if MRI is a financially viable option and identify a fast-scan sequence using the literature provided to recommend.


Methodology: A literature review was conducted. Five databases were searched followed by hand-searching to gain a deep pool of literature. All articles meeting the inclusion criteria were critically appraised using critical appraisal tools.


Findings: MRI is a specific tool and good for excluding fractures and has the benefit of no ionizing radiation. It is also shown in research to be cost effective, especially if no fracture is present and can further save costs through time off work. A fast-scan protocol of coronal T1 and STIR sequences was suggested.


Conclusion: Further research within the UK with larger samples and better reference standards is required to validate findings of current literature.

Citation

Lannie, J., & St. John-Matthews, J. (2016, October). The role of Magnetic Resonance Imaging (MRI) in the diagnosis and management of patients with suspected scaphoid fractures. Poster presented at Annual Conference. British Association of MR Radiographers (BAMRR), Cardiff, Wales, UK

• Presentation Conference Type: Poster
• Conference Name: Annual Conference. British Association of MR Radiographers (BAMRR)
• Conference Location: Cardiff, Wales, UK
• Start Date: Oct 1, 2016
• End Date: Oct 1, 2016
• Acceptance Date: Jun 20, 2016
• Publication Date: Jan 1, 2016
• Publicly Available Date: Jun 7, 2019
• Peer Reviewed: Not Peer Reviewed
• Keywords: MRI, scaphoid, imaging, suspected
• Public URL: https://uwe-repository.worktribe.com/output/920689
• Additional Information: Title of Conference or Conference Proceedings : British Association of MR Radiographers