Yvonne Yee Cheung MD, Abstract Co-Author: Nothing to Disclose

Brett Hanscom, Abstract Co-Author: Nothing to Disclose

Scott R Naspinsky, Presenter: Nothing to Disclose

James M Murphy MD, Abstract Co-Author: Nothing to Disclose

John T Nutting MD, Abstract Co-Author: Nothing to Disclose

Douglas Wayne Goodwin MD, Abstract Co-Author: Nothing to Disclose

In both the orthopedic and radiologic literature, increased density in the proximal pole (PP) of the scaphoid has been reported as a sign of complication, such as avascular necrosis, in the healing of scaphoid fractures. The purpose of this study is to investigate the association between the relative increase in Houndsfield units (HU) of the proximal pole and the status of scaphoid fracture.

We retrospectively reviewed all CT exams of the wrist in between January 2002 to March 2004. We divided the patients into three groups: normal scaphoid (n=23), healed scaphoid fracture treated by casting (n=22) and non-union (n=16). For the healed fracture group, HU measurements were made on the very last CT exam obtained prior to discharge of care. For the non-union group, the measurements were acquired from the CT exam prior to surgery. Exclusion criteria include those treated surgically and those lost to follow-up. Using a constant region of interest (1 cm 2), we measured the HU of the proximal pole and distal pole. The ratios of proximal pole to distal pole (PP/DP) were calculated.

1)The density ratios (PP/DP)between the proximal to distal pole of the scaphoid are not statistically different among the three groups. 2)Even though the ratios are the same, both the PP and DP CT densities are significantly higher in the non-union group than in the cast/healed and normal groups. 3)There is a significant relationship between gender and HU. Among the normals, males have higher CT density (both PP and DP) than females. Among the cast/healed patients, males and females seem to have similar CT densities (both PP and DP).

The HU measurement of the proximal pole relative to the distal pole is similar among our three groups of patients: those without scaphoid fracture, those with healed fracture and those with non-union. Therefore, relative increased density measurement in the proximal pole alone has no association with the status of fracture healing.

Cheung, Y, Hanscom, B, Naspinsky, S, Murphy, J, Nutting, J, Goodwin, D, Does Increase Radiodensity of the Proximal Pole of Scaphoid Correlate with the Status of Fracture Healing.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4411504.html