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.