Which imaging modality is often used to confirm occult scaphoid fractures when X-ray is negative?

• A. MRI
• B. Ultrasound
• C. Bone scan
• D. CT scan

Answer: (A)

When scaphoid fracture is suspected but X-rays are negative, MRI is the imaging test of choice because it can detect bone marrow edema and an occult fracture that radiographs miss. Its high sensitivity allows early confirmation and guides management to protect blood supply and reduce the risk of nonunion or avascular necrosis. While CT is excellent for detailing fracture lines once a fracture is known, it may miss very early injuries since it focuses on cortical bone. Bone scans are sensitive but less specific and slower, and ultrasound isn’t reliable for scaphoid fractures. So MRI provides the most accurate confirmation when X-ray results are negative.