With the ability to non-invasively display different viability patterns in the scaphoid bone, contrast-enhanced MRI is a powerful tool for detection and staging of Preiser’s disease. To our best knowledge, this study includes the largest patient sample undergoing MRI for idiopathic osteonecrosis of the scaphoid to date, thus expanding the knowledge on this rare disease entity. Our results suggest that the size of scaphoid necrosis is considerably overestimated in unenhanced MRI because necrotic bone cannot be reliably differentiated from vascularized repair tissue. Influencing decision on therapy, the extent of osteonecrosis should consequently not be assessed without administration of contrast agent.
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