Comparative Study Between Role of Computed Tomography and Magnetic Resonance Imaging in Scaphoid Fracture Diagnosis

Abstract

Background: Fractures of the scaphoid are the second most common fractures of the upper limb after distal radius fractures. Rapid and accurate diagnosis is needed, because delayed initiation of therapy increases the risk of complications such as non-union and avascular necrosis. Objectives: To compare between the diagnostic accuracies of Computed Tomography and Magnetic Resonance Imaging in detecting scaphoid fractures and its complications. Methods: This study was carried out on 30 patients presented to private Hand clinic from October 2018 to December 2019, with clinical symptoms of tenderness in the anatomic snuffbox after wrist trauma and suspected to have scaphoid fracture in the plane X-ray. They were invited to enroll in a comparison of CT and MRI with regard to their diagnostic utility. Results: The mean age for study participants was 31.8 years (SD = 12.6 years). Nineteen patients (66.7%) had horizontal fractures, 10 had oblique structures (33.3). The MDCT showed that 29 patients had cortical fractures, MRI showed that 27 had cortical fractures, 2 patients had mixed fractures and one patient had a trabecular fracture. Conclusion: Multidetector CT had the superiority over MRI in detection of cortical involvement in scaphoid fractures but MDCT was inferior to MRI in detection of trabecular scaphoid fractures. MRI was superior to MDCT in early detection of stage I Scaphoid non-union advanced collapse. MRI was superior to CT in early detection of avascular necrosis of proximal segment of scaphoid bone.