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Excellence in the Physical Exam Series | The Scaphoid Bone

Mike Weinstock, MD
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Up to 10% of initial radiographs fail to detect a fracture, so initial treatment should be directed by clinical suspicion

1/4 patients who present with scaphoid tenderness and initially negative x-rays will be subsequently diagnosed with a scaphoid fracture

MRI has a sensitivity of 88% (95% CI 64-97) and specificity of 100% (95%)

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Julie H. -

please talk a little about splinting - what KIND of splint for this type of injury (concern about possible scaphoid fx) if patient and provider elect to wait on advanced imaging. thanks!

Mike W., MD -

The goal is to immobilize the wrist so an OCL splint could be used, but I prefer the velcro thumb spica as it is quick and easy and has good immobilization. Thx for reaching out!
M

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Can't We All Just Get Along? Full episode audio for MD edition 204:00 min - 96 MB - M4AUC RAP January 2019 Written Summary 375 KB - PDF

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