Imaging the scaphoid problem : a diagnostic strategy for suspected scaphoid fractures

Imaging the scaphoid problem : a diagnostic strategy for suspected scaphoid fractures

Beeres, F.J.P.

Citation

Beeres, F. J. P. (2008, May 14). Imaging the scaphoid problem : a diagnostic strategy for suspected scaphoid fractures. Retrieved from https://hdl.handle.net/1887/12857

Version: Corrected Publisher’s Version

License: Licence agreement concerning inclusion of doctoral thesis in the Institutional Repository of the University of Leiden

Downloaded from: https://hdl.handle.net/1887/12857

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References

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Imaging protocols

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Scaphoid radiographs

Initial scaphoid radiographs were carried out in three planes: (1) a postero-anterior view with the hand in a neutral position, (2) an oblique view with the wrist in 10° of supination and maximal ulnar deviation and (3) a true lateral view with the wrist resting in the ulnar position on the x-ray plate. First, all radiographs were judged by the attending resident surgeon in the Emergency Department and a resident radiologist. Subsequently the consultant trauma surgeon and consultant radiologist judged the radiographs. All responses had to be negative to have an overall negative reading and to be eligible for study inclusion.

Bone scintigraphy

Bone scintigraphy was performed between three and five days after trauma, using a standard protocol of images of the early static phase, on a Sky-Light gamma camera (Philips, Eindhoven, the Netherlands). Palmar and dorsal images of both wrists were performed between two and a half and four hours after the injection of 500 MBq of Technetium-99m diphosphonate (Tc-99m-HDP) visualising the osteoblast activity. For every patient both sides were visualised.

Magnetic Resonance imaging

A 1.5 Tesla MR scan (Siemens, Erlangen, Germany) was used. The patient lies prone on the scanner couch with the hand (suspected of a scaphoid fracture) extended forward palm down over the patient’s head. A flexible surface coil was wrapped around the wrist. The MR imaging protocol included coronal T1-weighted turbo spin-echo images with a TR of 450 msec, a TE of 13 msec, a field view of 180 mm, a base resolution of 512, two averages, a slice thickness of 3 mm with a distance factor of 10%, and a scan time of 2.17 minutes.

The parameters for the coronal fat-suppressed T2-weighted fast spin-echo images were 5220/73 msec (TR/TE), a field of view of 220 mm, a base resolution of 448, three averages, a slice thickness of 3 mm with a distance factor of 10%, and a scan time of 4.33 minutes.

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List of publications

118

1. F.J.P. Beeres, M. Hogervorst, P. Hollander den, S.J. Rhemrev.

Outcome of routine bone scintigraphy in suspected scaphoid fractures.

Injury 2005; 36:1233-1236

2. F.J.P. Beeres, M. Hogervorst, P. Hollander den, S.J. Rhemrev.

Diagnostic management of suspected scaphoid fractures in the presence of other carpal injuries.

The Journal of Hand Surgery 2006; 31:416-418 3. F.J.P. Beeres, L.M. Kingma, et al.

Imaging of the hand, techniques and pathology: a pictorial essay.

Journal Belge de Radiologie - Belgisch Tijdschrift voor Radiologie 2007; 90:395-455 4. F.J.P. Beeres, S.J. Rhemrev, R. Kooijman, M. Hogervorst.

Unorthodox treatment of a very rare forearm injury.

Osteosynthesis and Trauma Care 2006; 4:225-229

5. F.J.P. Beeres, S.J. Rhemrev, M. Hogervorst, P. Hollander den, G.N. Jukema.

Scaphoid fractures: diagnosis and therapy.

Nederlands Tijdschrift voor Geneeskunde 2007; 31:151:742-747

6. F.J.P. Beeres, M. Hogervorst, S.J. Rhemrev, P. Hollander den, G.N. Jukema.

A prospective comparison for suspected scaphoid fractures: bone scintigraphy versus clinical outcome.

Injury 2007; 38:769-774

7. F.J.P. Beeres, M. Hogervorst, S.J. Rhemrev, S. Le Cessie, J.W. Arndt, M.P.M. Stokkel, K.A. Bartlema, J.F. Hamming.

Reliability of bone scintigraphy for suspected scaphoid fractures.

Clinical Nuclear Medicine 2007; 32:835-838

8. F.J.P. Beeres, M. Hogervorst, L.M. Kingma, S. Le Cessie, E.G. Coerkamp, S.J. Rhemrev.

Observer variation of MR imaging of suspected scaphoid fractures.

British Journal of Radiology 2008; in press

9. F.J.P. Beeres, S.J. Rhemrev, M. Hogervorst, S. Le Cessie, K.A. Bartlema, J.F. Hamming.

Strength measurements improves the diagnostic strategy of suspected scaphoid fractures.

Submitted

10. F.J.P. Beeres, P. Hollander den, S. Le Cessie, K.A. Bartlema, J.F. Hamming, M. Hogervorst.

Acute MR imaging compared with bone scintigraphy in suspected scaphoid fractures.

Submitted

119

Curriculum Vitae

122

123 C u rriculum V itae The author of this thesis was born on the 2

of June 1982 in Leidschendam, the

Netherlands. He moved to Belgium with his parents and sister where he graduated from the European School of Brussels I with a European Baccalaureate, in 2000. He started studying for his medical degree at the Leiden University Medical Centre, the Netherlands, in 2000. During his medical studies he worked as a student assistant for practicals and tutorials at the department of anatomy at the Leiden University Medical Centre and also undertook a two months clinical elective at Dundee’s University Hospital in Scotland. He started his research while still an undergraduate student, in 2004. The research was conducted at the Medical Centre Haaglanden, the Netherlands, resulting in this thesis.

The author obtained his medical qualification in 2006. He then carried out a three months

internship at the World Health Organisation in Geneva, Switzerland, in the department

of Health Action in Crisis. In July 2007, he started his surgical education under the

supervision of J.C.A. de Mol van Otterloo MD PhD at the Medical Centre Haaglanden.