What is the best imaging test for patients with suspected scaphoid fractures and normal plain radiographs?

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Abstract

EVIDENCE-BASED ANSWER

For a patient with a suspected scaphoid fracture but normal plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy are all reasonable next-step imaging modalities (SOR: A, meta-analysis of cohort studies). From a healthcare spending perspective, CT or MRI may be more cost effective than a strategy of immobilization with follow-up after 2 weeks for repeat plain radiographs and orthopedic consultation (SOR: B, cost-effectiveness analysis).

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