Potential of scintigraphy in early diagnosis of scaphoid bone fractures

Over a period of 26 months patients with suspected fracture of the scaphoid bone and a negative X-ray diagnosis were examined using 99mTc-MDP scintigraphy. Twenty one patients were examined - 16 men and five women in the age group between 15 and 57 years. It was found that in the first 48 hours after the accident there was an increased diffusion retention of the nuclide in the area of the wrist. Insofar as the said process continued even after 72 hours and later, it signified a lesion of the soft structures and fracture could be excluded. Typical of the fracture was a round focus of increased deposition of the nuclide in the scaphoid area which was there even after 72 hours and later. Scintigraphy allows to shorten the time needed for diagnosis in controversial cases from several weeks to several days which allows for adequate therapy to be administered to patients who are not suffering from a fracture and to not require fixation. Fracture may be excluded in all cases where there is no abnormal scintigraphic finding. (author)