DOS Kongressen 2014 ·
231
MRI IMAGING AND PATHOLOGY OF AVASCULAR
NECROSIS IN THE PROXIMAL POLE OF THE
SCAPHOID BONE AFTER FRACTURE
Britt Mejer, Niels Søe, Nina Vendel Jensen, Katalin Kiss, Lone Larsen,
Lars B. Dahlin
Ortopædkirurgisk O, Hillerød Hospital; Håndkirurgisk klinik, Gentofte
Hospital; Anæstesiologisk afdeling, Gentofte Hospital; Patologisk afdeling,
Rigshospitalet; Radiologisk afdeling, Herlev Hospital; Håndkirurgisk afdeling,
Malmø og Lund sykehus
Background:
MRI imaging is considered the gold standard in order to diagnose
avascular necrosis after a scaphoid fracture prior to surgery
Purpose / Aim of Study:
A comparative study on ten patients who suffered
from scaphoid fracture with avascular proximal pole necrosis was done, where
MRI images with contrast were compared against histological findings of the
excised proximal pole of the scaphoid bone. We reviewed the accuracy of MRI
findings compared to histological findings of the entire proximal pole of the sca-
phoid.
Materials and Methods:
A comparative study on ten patients who suffered
from scaphoid fracture with avascular proximal pole necrosis was done, where
MRI images with contrast were compared against histological findings of the
excised proximal pole of the scaphoid bone. The patients were initially treated
with screw fixation due to a fracture, but due to avascular necrosis of the proxi-
mal pole they were reoperated with APSI prosthesis. Prior to surgery all patients
were examined with X-ray and MRI that both showed the signs of necrosis of
the proximal pole of the scaphoid.
Findings / Results:
All ten patients showed different degrees of avascular
proximal pole necrosis in ordinary X-ray, and the histological findings showed
more extensive necrosis in the bone than the MRI. The histological findings are
more precise in the degree of vascularity than the MRI.
Conclusions:
MRI findings seem to be less specific than the histological findings
described with degree of avascular necrosis. The MRI technique with contrast
that is used now will probably better correlate to histological findings.
178.
