Detecting fractures of the scaphoid: the value of comparative X-rays of the uninjured wrist.

Pain or tenderness in the anatomical snuff-box following trauma suggests an injury to the scaphoid or surrounding soft tissues. It is often difficult to make a definite diagnosis since normal bone markings across the scaphoid can be misinterpreted as a fracture. To clarify whether a fracture is present or not, an X-ray of the uninjured scaphoid is taken in a comparable position to the most suspicious view. If bone markings are similar on both views, then a fracture can be excluded. Conversely, if the bone markings differ, then suspicion of a fracture may be confirmed. In combination with the clinical features, a more accurate diagnosis can be made and unnecessary out-patient and X-ray reviews can be avoided.