The efficacy of plain films vs MRI in the detection of scaphoid fractures

An investigation was carried out to determine whether or not professionals perceived plain film radiography to be the ‘gold-standard’ in the detection of scaphoid fractures. Literature highlighted that plain film radiography was an unreliable method for detecting such fractures and that magnetic resonance imaging (MRI) should now be regarded as the new ‘gold-standard’. Using a quantitative method, a total of 100 postal questionnaires were sent out to radiologists in 20 different imaging departments throughout the United Kingdom (UK) asking them their opinion on this controversial subject. In addition, the investigation looked into the use of MRI within each department in trying to determine whether or not it was surpassing plain film radiography as an established practice for detecting scaphoid fractures. Of the 100 questionnaires that were sent out, a total of 45 were returned from a total of 13 different departments. The results of this investigation conclude that plain film radiography is still used as a primary imaging modality to detect scaphoid fractures in all departments. There was much support for the use of plain film radiography with the modality being praised time and time again for its ease, 24-h availability, low cost and reproducibility. MRI was acknowledged as being superior in its capability to detect scaphoid fractures in comparison to plain films; its current use, however, is limited owing to high costs, lack of availability and long waiting lists. It would appear from this study that MRI is regarded as a useful modality in cases whereby plain film radiography fails to detect the presence or absence of a fracture in clinically positive patients, with great future potential. Keywords: Radiography; Magnetic resonance imaging; Scaphoid; Fractures; Diagnostic imaging; Orthopaedics