What is the role of MRI in the evaluation of scaphoid fractures?
The role of MRI in the evaluation of scaphoid fractures is not only for the detection of radiographically occult fractures as in other carpal bones, but also for the diagnosis of osteonecrosis of the proximal pole of the scaphoid bone. The latter entity arises from disruption of the vascular supply that enters through the proximal pole, predisposes to nonunion, and necessitates a change in therapy. The presence of low signal intensity in the proximal pole on all sequences is quite specific for osteonecrosis, but is not seen in all cases. Despite some initial enthusiasm for the use of intravenous contrast material, this probably does not increase the accuracy of MRI for this diagnosis.
