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Value of bone scintigraphy in patients with carpal trauma

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Abstract

Objective

We planned this study to evaluate the role of bone scintigraphy in patients with suspected carpal fracture and normal or suspicious radiographs following carpal injury.

Methods

Three-phase bone scintigraphy using Tc-99m-MDP was performed on 32 patients with negative radiographs but clinically suspected fracture at two weeks after the trauma. Focally increased radiophar-maceutical uptake was interpreted as a fracture. The final diagnosis was established with clinical follow-up.

Results

Twelve (38%) patients had a normal scan excluding fracture. Twelve patients had a single fracture. Multifocal fracture was present in 8 (25%) patients. Eight patients showed scaphoid fractures; of these three showed single scaphoid fracture, and the other five patients revealed accompanying fractures. Distal radius fractures and carpal bone fractures other than scaphoid were both observed in 12 patients. These were eleven fractures of distal radius; three fractures of pisiform; two fractures of hamate; and single fractures of lunate, trapezium and triquetrum. In one patient there was fracture of a first metacarpal bone.

Conclusion

In patients with suspected carpal bone fracture and normal or suspicious radiographs, bone scintigraphy can be used as a reliable method to confirm or exclude the presence of a scaphoid fracture and to detect clinically unsuspected fractures of distal radius and other carpal bones.

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References

  1. Dobyns JH, Beckenbaugh RD, Bryan RS, Cooney WP, Linscheid RL, Wood MB. Fractures of the Hand and Wrist. In:Hand Surgery, Flynn JE (ed), 3rd ed. Baltimore; Williams & Wilkins, 1982: 111–180.

    Google Scholar 

  2. Tiel-van Buul MM, Roolker W, Broekhuizen AH, Van Beek FJ. The diagnostic management of suspected scaphoid fracture.Injury 1997; 28(1):1–8.

    Article  PubMed  CAS  Google Scholar 

  3. Brondum V, Larsen CF, Skov O. Fracture of the carpal scaphoid: frequency and distribution in a well-defined population.Eur J Radiol 1992; 15(2):118–122.

    Article  PubMed  CAS  Google Scholar 

  4. Barton NJ. Twenty questions about scaphoid fractures.J Hand Surg (Br) 1992; 17:289–310.

    CAS  Google Scholar 

  5. Murphy D, Eisenhauer M. The utility of a bone scan in the diagnosis of clinical scaphoid fracture.J Emerg Med 1994; 12 (5):709–712.

    Article  PubMed  CAS  Google Scholar 

  6. Roolker W, Tiel-van Buul MM, Broekhuizen AH, Eikelenboom AK, van RoyenEA. Improved wrist fracture localization with digital overlay of bone scintigrams and radiographs.J Nucl Med 1997; 38 (10):1600–1603.

    PubMed  CAS  Google Scholar 

  7. Tiel-van Buul MM, van Beek EJ, Dijkstra PF, Bakker AJ, Broekhuizen TH, van Royen EA. Significance of a hot spot on the bone scan after carpal injury—evaluation by computed tomography.Eur J Nucl Med 1993; 20(2):159–164.

    Article  PubMed  CAS  Google Scholar 

  8. Rolfe EB, Garvie NW, Khan MA, Ackery DM. Isotope bone imaging in suspected scaphoid trauma.Br J Radiol 1981; 54(645):762–767.

    Article  PubMed  CAS  Google Scholar 

  9. Brown JN. The suspected scaphoid fracture and isotope bone imaging.Injury 1995; 26 (7):479–482.

    Article  PubMed  CAS  Google Scholar 

  10. Brismar J. Skeletal scintigraphy of the wrist in suggested scaphoid fracture.Acta Radiol 1988; 29(1):101–107.

    PubMed  CAS  Google Scholar 

  11. Shewring DJ, Savage R, Thomas G. Experience of the early use of technetium 99 bone scintigraphy in wrist injury.J Hand Surg(Br) 1994; 19 (1):114–117.

    Article  CAS  Google Scholar 

  12. Mohamed A, Ryan P, Lewis M, Jarosz JM, Fogelman I, Spencer JD, et al. Registration bone scan in the evaluation of wrist pain.J HandSurg (Br) 1997; 22(2):161–166.

    CAS  Google Scholar 

  13. Roolker W, Maas M, Broekhuizen AH. Diagnosis and treatment of scaphoid fractures, can non-union be prevented?Arch Orthop Trauma Surg 1999; 119 (7-8):428–431.

    Article  PubMed  CAS  Google Scholar 

  14. Tiel-van Buul MM, van Beek EJ, van Dongen A, van Royen EA. The reliability of the 3-phase bone scan in suspected scaphoid fracture: inter- and intraobserver variability analysis.Eur J Nucl Med1992; 19(10):848–852.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Ümit Ö. Akdemir.

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Akdemir, Ü.Ö., Atasever, T., Sipahioğlu, S. et al. Value of bone scintigraphy in patients with carpal trauma. Ann Nucl Med 18, 495–499 (2004). https://doi.org/10.1007/BF02984566

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  • DOI: https://doi.org/10.1007/BF02984566

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