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16-MDCT in the Detection of Occult Wrist Fractures: A Comparison with Skeletal Scintigraphy

Ashley M. Groves1, Heok Cheow2, Kottekkattu Balan2, Helen Courtney1, Philip Bearcroft1 and Adrian Dixon1

1 Department of Radiology, Addenbrooke's Hospital NHS Trust and the University of Cambridge, Box 218, Hills Rd, Cambridge CB2 2QQ, England.
2 Department of Nuclear Medicine, Addenbrooke's Hospital NHS Trust and the University of Cambridge, Cambridge, England.



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  		Fig. 1A. —56-year-old woman with persistent wrist pain after fall. Local-view 99mTc-MDP skeletal scintigram of wrist shows focal uptake of tracer in left scaphoid. R = right.

 


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  		Fig. 1B. —56-year-old woman with persistent wrist pain after fall. Coronal CT reconstruction of wrist shows severe arthropathy causing difficulty in identifying fracture. Image has been reversed to match A.

 


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  		Fig. 2A. —19-year-old man with wrist pain after fall. Local-view 99mTc-MDP skeletal scintigram of wrist shows focal uptake of tracer in right scaphoid. R = right.

 


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  		Fig. 2B. —19-year-old man with wrist pain after fall. Coronal CT reconstruction of wrist shows no evidence of fracture. Image has been reversed to match A.

 


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  		Fig. 3A. —22-year-old woman with persistent wrist pain after fall. Coronal CT reconstruction of wrist shows no evidence of fracture. Image has been reversed to match B.

 


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  		Fig. 3B. —22-year-old woman with persistent wrist pain after fall. Local-view 99mTc-MDP skeletal scintigram of wrist shows increased focal tracer uptake in right capitate. R = right.

 


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  		Fig. 3C. —22-year-old woman with persistent wrist pain after fall. Follow-up radiograph 6 weeks after injury shows no fracture. Distortion to bony contour, but no associated sclerosis, is observed. Image has been reversed to match B.

 

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