Tag Archives: occult fracture

Wrist Scaphoid View
4
Feb

Overview

The scaphoid view positions the wrist in ulnar deviation to elongate the scaphoid and improve fracture detection. It is obtained when scaphoid injury is suspected despite normal standard views. Early detection prevents non union and long term dysfunction.

Technique

Ask the patient to ulnar deviate the wrist and center the detector to the scaphoid waist. Use a slight cranial tube angle if needed to profile the scaphoid. Immobilize the wrist and minimize motion during exposure.

Clinical Indications

Scaphoid view is indicated for snuffbox tenderness and suspected scaphoid fracture. It complements PA and lateral views and may be followed by dedicated CT or MRI if radiographs are inconclusive. Early immobilization is recommended when clinical suspicion is high.

Image Assessment

Inspect the scaphoid waist and proximal pole for cortical disruption and sclerosis. Evaluate for associated radial styloid fractures and carpal instability. Report findings and recommend further imaging if needed.

Elbow Radial Head View
4
Feb

Overview

The radial head view profiles the radial head and neck to detect subtle fractures and impaction injuries. The projection is obtained with the elbow flexed and the beam angled to profile the radial head. This view complements standard AP and lateral elbow radiographs.

Technique

Position the elbow in partial flexion and rotate the hand to profile the radial head. Use a small focal spot and tight collimation for detail. Immobilize the limb to minimize motion artifact.

Clinical Indications

Radial head views are indicated for trauma with lateral elbow pain and suspected radial head fracture. They help detect nondisplaced fractures that may be occult on standard views. CT or MRI may be used for complex or occult injuries.

Image Assessment

Evaluate radial head cortical continuity articular surface and neck for fracture lines. Assess for joint effusion and associated capitellar injury. Report findings relevant to orthopedic management.

Scaphoid Axial View
4
Feb

Overview

The axial scaphoid view images the scaphoid in a different plane to better visualize the proximal pole and waist. It is obtained with specialized positioning to elongate the scaphoid. This view aids in detecting fractures that may be occult on standard projections.

Technique

Position the wrist in ulnar deviation and apply a specific tube angle to project the scaphoid axially. Center to the scaphoid and use tight collimation for detail. Immobilize the wrist to minimize motion artifact.

Clinical Indications

Axial scaphoid views are indicated when standard scaphoid projections are inconclusive and clinical suspicion remains high. They help detect proximal pole fractures and guide immobilization decisions. MRI or CT is used for definitive diagnosis when radiographs are negative.

Image Assessment

Inspect the scaphoid waist and proximal pole for cortical disruption and sclerosis. Evaluate for associated radial styloid fractures and carpal instability. Report findings and recommend advanced imaging if needed.

Bone Scintigraphy Whole Body Bone Scan
4
Feb

Overview

Bone scans use technetium labeled phosphonates to detect increased osteoblastic activity across the skeleton with high sensitivity.

Technique

Planar and SPECT acquisitions with appropriate timing after tracer injection identify focal uptake patterns.

Clinical Uses

Metastatic disease screening occult fracture detection and infection and inflammation assessment.

Limitations and Safety

Low specificity. Correlation with other imaging and clinical data is required.