|It would be fair to say that there are lots of small studies published that deal with the diagnostic approach to scaphoid fractures. This includes examination of the role of advanced medical imaging.|
- Immobilise, repeat XR and clinical examination
- Bone scan
While there are advocates for MRI as the gold standard, and it provides excellent images, I do not believe it has been definitely proven as the gold standard.
Secondly, local resource availability is a major factor.
Thirdly, there is a reasonable argument to immobilise patients with significant pain and tenderness, and maintain immobilisation with periodic reassessment. This is particularly true if CT is normal. No displacement, no missed fractures, minimal risk.