HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hauger, O. Articles by Diard, F. Search for Related Content PubMed PubMed Citation Articles by Hauger, O. Articles by Diard, F. Social Bookmarking                      What's this?

Occult Fractures of the Waist of the Scaphoid

Early Diagnosis by High-Spatial-Resolution Sonography

¹ Service de Radiologie, Groupe Hospitalier Pellegrin, CHRU Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France.
² Service de Radiologie, Centre Hospitalier Général de Pau, 4 Blvd. Hauterive, 64000 Pau, France.

View larger version (103K): [in a new window]   Fig. 1A. —Optimal positions for sonography of scaphoid bone. Photographs show wrist placed in ulnar deviation in either frontal (A) or sagittal (B) planes to elongate scaphoid. This position allows optimal visualization of its waist.

View larger version (130K): [in a new window]   Fig. 1B. —Optimal positions for sonography of scaphoid bone. Photographs show wrist placed in ulnar deviation in either frontal (A) or sagittal (B) planes to elongate scaphoid. This position allows optimal visualization of its waist.

View larger version (96K): [in a new window]   Fig. 2. —21-year-old woman with acute trauma of wrist and moderate suspicion of scaphoid fracture. Longitudinal sonograms show scaphoid with wrist in ulnar deviation. Hemarthrosis is defined as compressible and diffuse collection at level of scaphoid.

View larger version (75K): [in a new window]   Fig. 3. —37-year-old man with acute trauma of wrist and high suspicion of scaphoid fracture. Longitudinal sonogram shows scaphoid with wrist in ulnar deviation. Hematoma is defined as no or less compressible collection at same level as in Figure 2. Cursors indicate superior and inferior limits of hematoma (i.e., its thickness) without and with compression.

View larger version (161K): [in a new window]   Fig. 4A. —25-year-old man with acute trauma of left wrist and moderate suspicion of scaphoid fracture. Initial conventional radiograph shows no evidence of fracture.

View larger version (47K): [in a new window]   Fig. 4B. —25-year-old man with acute trauma of left wrist and moderate suspicion of scaphoid fracture. High-resolution sonogram of scaphoid obtained in transverse plane shows cortical disruption suggestive of fracture (arrow) with surrounding hematoma (arrowheads). Opposite side is shown as reference.

View larger version (147K): [in a new window]   Fig. 4C. —25-year-old man with acute trauma of left wrist and moderate suspicion of scaphoid fracture. Conventional radiograph obtained 14 days after initial radiograph (same view as A) shows fracture line (arrow) through scaphoid bone.

View larger version (140K): [in a new window]   Fig. 5A. —26-year-old man with acute trauma of left wrist and high suspicion of scaphoid fracture. Initial conventional radiograph shows no evidence of fracture.

View larger version (114K): [in a new window]   Fig. 5B. —26-year-old man with acute trauma of left wrist and high suspicion of scaphoid fracture. High-resolution sonogram obtained in sagittal plane with wrist in ulnar deviation shows incompressible collection (arrowheads) at level of scaphoid suggesting hematoma.

View larger version (134K): [in a new window]   Fig. 5C. —26-year-old man with acute trauma of left wrist and high suspicion of scaphoid fracture. Two-dimensional reconstruction of CT scan obtained in frontal plane 2 weeks after trauma shows no evidence of fracture despite persistence of clinical suspicion.

View larger version (83K): [in a new window]   Fig. 5D. —26-year-old man with acute trauma of left wrist and high suspicion of scaphoid fracture. Delayed high-resolution sonogram shows resolution of hematoma.

View larger version (163K): [in a new window]   Fig. 6A. —33-year-old man with acute trauma of left wrist and high suspicion of scaphoid fracture. Initial conventional radiograph shows no evidence of fracture.

View larger version (134K): [in a new window]   Fig. 6B. —33-year-old man with acute trauma of left wrist and high suspicion of scaphoid fracture. High-resolution sonogram obtained in sagittal plane shows hyperechogenic line (arrowheads), parallel to scaphoid cortex that is more likely related to positive echo signal of anterior interface of cartilage induced by high gain level than to subperiosteal hematoma, because scaphoid is almost entirely covered with cartilage.

View larger version (138K): [in a new window]   Fig. 6C. —33-year-old man with acute trauma of left wrist and high suspicion of scaphoid fracture. Delayed two-dimensional reconstruction of CT scan obtained in frontal plane shows no evidence of fracture.

View larger version (18K): [in a new window]   Fig. 7. —Proposed algorithm for imaging of suspected scaphoid bone fracture.

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati