What can detect a scaphoid fracture better, an x-ray or an MRI?

Question

Hi doctor,

I have been feeling wrist pain for a few weeks now. No recent injury, but I had an injury a few months back. I had foot surgery and fell off my scooter, and landed on my wrist. I was on crutches and needed my wrists, so I dealt with the pain, which was very painful. The pain went away and just resurfaced. It is on both sides (palm and dorsal), and it hurts in extension (more pain), flexion, and ulnar deviation (more pain). I have been wrapping it daily and even have a wrist brace, but it is not getting better. Pain is A 4-4 constant dull ache, and when moving, I got sharp shooting pains of like 7 on the pain scale. Currently, I have Ibuprofen and Tylenol occasionally.

Answer 1

Hi,

Welcome to icliniq.com.

The area (attachment removed to protect patient identity) you have marked is an area of the scaphoid bone. Do you have any X-rays or other investigations?

Answer 2

Hi,

Welcome back to icliniq.com.

I think you should get an X-ray done of your wrist area. Sometimes there will be a fracture of the scaphoid bone, which manifests later. You might need MRI (magnetic resonance imaging) also. I request you to read about scaphoid bone fracture online.

I hope this was helpful.

Answer 3

Hi,

Welcome back to icliniq.com.

Yes, use a thumb spica brace to restrict movements of the thumb. This fracture requires a long period of casting and may even require surgery and bone grafting. It has been two days. Have you not got your X-rays done?

Kindly follow up with the reports.

Answer 4

Hi,

Welcome back to icliniq.com.

Well, I do not think the second point is that significant. Sometimes the scaphoid fracture is not seen on X-rays, and you need to get an MRI (magnetic resonance imaging) for that, as I have said earlier. So you should approach your orthopedic surgeon, and he will advise you MRI after the examination. Do not worry about the second point. It is normal.

Answer 5

Hi,

Welcome back to icliniq.com.

Yes, some calcification is normal. So nothing to worry about that. You should wear a thumb spica as per your pain. If pain is more, then wear it most of the time, and if it is bearable, you can use it when you are doing some heavy activities, which might increase your pain. So the decision is yours. Well, I feel chronic pain in that area, especially after a history of fall on outstretched hand should be investigated for scaphoid fracture. It might be possible that your MRI comes out normal, but ideally, it should be done.

Thanks.

Answer 6

Hi,

Welcome back to icliniq.com.

So basically, the purpose of the splint is to prevent pain that is bothering you. Suppose you are comfortable with that pain, then no need to use it. If not, then you should use it. Fracture has nothing to do with a splint. Would you please let me know whatever comes in the MRI?

Thanks.