VALOR DE LA RESONANCIA MAGNETICA PRECOZ EN EL DIAGNOSTICO DE FRACTURAS DE ESCAFOIDES

Abstract

Introduction: In cases of clinically suspected scaphoid fracture, without radiographic evidence, immobilization and symptomatic treatment is recommended. The use of MRI would define how many of this cases actually present scaphoid fracture, modifying treatment. Materials and methods: In 15 patients with clinically suspected scaphoid fracture and negative radiograph, MRI exams were done 9 days or earlier after trauma. The study included coronal turbo-spin-echo (TSE) T1 weighted images and coronal short tau inversion recovery (STIR) sequences. Results: MRI showed occult scaphoid fractures in 5 patients (33%), with the combination of T1 and STIR sequences. Patients with negative radiograph and MRI studies reintegrated to normal activities in a period shorter than 2 weeks after trauma. As a consequence there was a reduction in economic costs of at least 50% considering only radiologic studies, and decreased number of medical consultation. Discussion: MRI early after trauma show a high sensitivity detecting scaphoid fractures radiographically occult, allowing early diagnosis and treatment, avoiding unnecessary immobilization and reducing costs in those patients without fracture.