Occult fractures of the scaphoid. The diagnostic usefulness and indirect economic repercussions of radiography versus magnetic resonance scanning.

Scaphoid fractures that are not visible on initial radiographs are notoriously difficult to diagnose. This prospective study compared four-view plain radiography at an average of 14 days after injury, with high-definition macroradiography and magnetic resonance imaging at presentation. Initial magnetic resonance imaging was superior to repeat scaphoid radiography for the confirmation or exclusion of fractures as well as for the detection of associated wrist injuries. Macroradiography was unsuitable for screening for occult scaphoid fractures.