SMaRT trialThe bone & joint journal 2019
Clinical and cost implications of using immediate MRI in the management of patients with a suspected scaphoid fracture and negative radiographs results from the SMaRT trial
Immediate MRI was associated with lower mean costs per patient; the saving was not statistically significant at three months but became significant at six months. MRI also picked up significantly more fractures other than the scaphoid and had higher diagnostic accuracy than standard care.
Randomised trialDiagnosisWrist
Duckworth scaphoid predictorsThe Journal of bone and joint surgery. British volume 2012
Predictors of fracture following suspected injury to the scaphoid
Male sex, sports injury, snuffbox pain on ulnar deviation within 72 hours and scaphoid tubercle tenderness at two weeks independently predicted fracture. Absence of snuffbox pain on ulnar deviation early on was associated with no fracture, and when all four factors were present the fracture risk was very high.
Cohort studyDiagnosisWrist
Mallee CT vs MRI scaphoidThe Journal of bone and joint surgery. American volume 2011
Comparison of CT and MRI for diagnosis of suspected scaphoid fractures
CT and MRI performed comparably with no significant difference in sensitivity, specificity or accuracy; both were better at excluding than confirming a fracture, and MRI produced more false positives.
Cohort studyDiagnosisWrist
Palmer TFCC classificationThe Journal of hand surgery 1989
Triangular fibrocartilage complex lesions: a classification
Class 1 traumatic tears are subdivided by site (central, ulnar, distal and radial attachments), and Class 2 degenerative lesions are graded progressively from TFCC wear through perforation, chondromalacia and lunotriquetral ligament tear to ulnocarpal arthritis, reflecting ulnar impaction.
OtherDiagnosisWrist
Mayfield perilunar instabilityThe Journal of hand surgery 1980
Carpal dislocations: pathomechanics and progressive perilunar instability
Defined four progressive stages of perilunar instability: scapholunate disruption, capitolunate disruption, lunotriquetral disruption and finally volar lunate dislocation.
OtherDiagnosisWrist