MR images demonstrating a fracture of the scaphoid waist. The important thing is as Dr Hollis Potter says, "You can't move protons in it on the PD sequence- it means it's dead bone".


There's also widening of the scapholunate joint.

So, from first consult to confirmation of diagnosis there can be a delay as initial scaphoid fractures can be radiographically occult. There is institutional variation in practice: some places use nuclear bone scan, and some use repeat radiography, and some use MRI. I prefer to image gently with MRI.

What about you?

Andy Groves at Cambridge has a very nice paper demonstrating this variation in pratice in the UK. Paper available here.