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Journal of Hand Surgery (European Volume)
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SCAPHOID BONE BRUISING – PROBABLY NOT THE PRECURSOR OF ASYMPTOMATIC NON-UNION OF THE SCAPHOID

N. LA HEI
I. MCFADYEN
M. BROCK
J. FIELD

From the Department of Orthopaedics, Cheltenham General Hospital, the Department of Orthopaedics, Bristol Royal Infirmary and the Department of Radiology, Cheltenham General Hospital, UK

Correspondence: Miss Nina La Hei, Gloucestershire Royal Hospital, Gloucester, UK. Tel.: +44 1453 757 978; fax: +44 8454 225 643. E-mail:ianina{at}doctors.org.uk

The MRI finding of bone marrow oedema, without fracture, following trauma to the scaphoid has been called a ‘bone bruise’. A similar injury is found in the knee, considered benign and managed conservatively. In the scaphoid, there is the concern that this lesion may lead to scaphoid non-union. This study addresses that concern. The clinical and radiological findings of 41 patients with a scaphoid bone bruise on MRI are described, an MRI classification system proposed and clinical outcomes investigated. Patients were immobilised for 6 weeks. At 3 months, 8 remained symptomatic and had repeat MRI. Four of these showed complete resolution of the bruise, the others improvement. At 6 months, 2 of the 8 complained of minor, intermittent discomfort but progressed to resolution of symptoms. This study suggests that the scaphoid bone bruise is a benign injury with predictable recovery and is unlikely to result in long-term morbidity in the form of non-union.

Key Words: scaphoid • bone bruise • magnetic resonance imaging • marrow oedema • scaphoid non-union

Journal of Hand Surgery (European Volume), Vol. 32, No. 3, 337-340 (2007)
DOI: 10.1016/J.JHSB.2006.09.018
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