Is there a place for radionuclide bone scintigraphy in the management of radiograph-negative scaphoid trauma?
OBJECTIVE: To evaluate the role of radionuclide bone scanning in patients with suspected scaphoid trauma, particularly in those with negative radiographs. DESIGN: Prospective. Radionuclide scans and carpal bone radiography were performed on all participants in the early post-injury period. SETTING: Cape Town tertiary centre trauma unit. PARTICIPANTS: Fifty patients who presented with clinical features suggestive of scaphoid trauma. MAIN OUTCOME MEASURE: Definitive radiographic diagnosis of fracture or persistent clinical features of scaphoid trauma. RESULTS: All patients who had fractures demonstrated on standard radiography either at the initial visit (13 patients) or at 2 weeks (8 patients) had positive scintiscans (sensitivity 100%). Four of 6 patients who had a positive scan but negative first and second radiographs had persistent tenderness on clinical examination which required extended immobilisation in a plaster cast. The overall positive predictive value of scintigraphy was 93
