Understanding Pediatric Clinical Scaphoid Injuries: A Prospective Radiological Study

Controversy exists in the management of children presenting with clinical suspicion of a scaphoid fracture but normal radiographs. The purpose of this study was to prospectively evaluate the potential role for advanced imaging in children with suspected scaphoid fractures. Participants with clinical suspicion of a scaphoid fracture but 2 sets of radiographs negative for fracture were casted and underwent both computed tomography (CT) and magnetic resonance imaging (MRI). The primary outcome was the prevalence of scaphoid fracture and other imaging findings. Twenty-five participants were enrolled. Nine participants (36%) were found to have a scaphoid fracture on either CT or MRI. Concordance of CT and MRI was found in 64% of cases. Future studies are required to better understand the clinical significance of these injuries, the role of advanced imaging, and the most appropriate treatment in children with suspected scaphoid fractures.