Occult fractures of the scaphoid are the fractures which are suspected clinically but do not show up in the xrays. Up to 30% of all scaphoid fractures may not be detected on initial xrays.
If an occult fracture of the scaphoid or severe concomitant wrist injury is suspected but not visible on initial x-rays, the wrist should be immobilized for 10 days in a forearm cast or splint, and the patient should be re-evaluated clinically as well raiologically.
MRI and radionuclide and MRI scans are reliable methods of diagnosing occult fractures of the scaphoid but are expensive investigations.
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