Scaphoid fracture: Bone marrow edema detected with dual-energy CT virtual non-calcium images and confirmed with MRI

Skeletal Radiol. 2017 Dec;46(12):1753-1756. doi: 10.1007/s00256-017-2730-6. Epub 2017 Jul 29.

Abstract

We aimed to determine whether bone marrow edema (BME) in acute traumatic scaphoid fracture could be demonstrated with dual-energy CT (DECT) using MRI as the gold standard. In recent years, virtual non-calcium (VNCa) images have been used to demonstrate BME in trauma cases, for example, in vertebral compression fractures, hip trauma to detect occult fractures and knee fractures. We present three cases of acute scaphoid trauma. Two patients had subtle or invisible fractures on x-ray and conventional CT images, while DECT VNCa images clearly visualized the BME, which was confirmed by MRI. One patient had negative findings on both VNCa and MRI images. The DECT VNCa algorithm is a promising technique to demonstrate BME in scaphoid fractures, with potential for increasing the diagnostic value of CT in this type of injury.

Keywords: Bone marrow edema; CT and MRI in occult scaphoid fracture; DECT VNCa images; Diagnosis of scaphoid fracture; Dual-energy CT virtual non-calcium images; Occult hip fracture; Vertebral compression fracture.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Diseases / diagnostic imaging*
  • Child
  • Diagnosis, Differential
  • Edema / diagnostic imaging*
  • Female
  • Fractures, Bone / diagnostic imaging*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Scaphoid Bone / diagnostic imaging*
  • Scaphoid Bone / injuries*
  • Tomography, X-Ray Computed / methods*