Scaphoid MRI
Research type
Research Study
Full title
A single centre randomised, non-blinded, prospective study to evaluate the use of MRI for patients presenting with suspected scaphoid fracture with negative findings on the initial conventional radiography.
IRAS ID
180601
Contact name
Tiago Rua
Contact email
Sponsor organisation
Guy's & St Thomas' Foundation NHS Trust
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 11 months, 2 days
Research summary
The scaphoid bone is an obliquely orientated bone on the radial (thumb) side of the wrist, between the distal carpal row and the radius (Hackney and Dodds 2011). Hand injury is a common presentation to the Emergency Department (ED) in the UK (Patel et al. 2013). However, of the patients presenting with wrist pain and tenderness at A&E, most do not present with an obvious scaphoid fracture (Patel et al. 2013). It is estimated that the majority (between two thirds and 84%) of patients presenting at A&E will have no definite bone injury at all (Patel et al. 2013), (Mallee et al. 2011).\n\nClinical and radiographic diagnosis of scaphoid fractures is often challenging, particularly at time of presentation. According to Nguyen et al. (2008) this situation might lead to underdiagnosis in up to 40% of cases, and subsequent undertreatment of scaphoid fracture, affecting patient outcomes, mostly in young people. To avoid potential clinical complications, clinicians tend to overtreat, leading to the excessive use of plaster casts. This can significantly affect a patient’s quality of life and their overall experience. \n\nThis study, a one-site randomised (GSTT), non-blinded, prospective trial, aims to evaluate the utilisation of Magnetic Resonance Imaging (MRI) in the diagnosis of adults presenting with suspected scaphoid fracture with negative findings on the initial conventional radiography. The proposed intervention is compared against the current standard of care, i.e. without the use of MRI. The primary objective is to evaluate if the proposed treatment is cost-saving at 3 months. A subsequent cost-effectiveness analysis will also take into account both the costs and outcomes related to the intervention.\n\nAs a result of this study, we aim to generate statistically significant UK-based evidence around the use of MRI for patients presenting at the A&E/UCC departments with suspected scaphoid fracture.
REC name
London - Surrey Research Ethics Committee
REC reference
16/LO/0826
Date of REC Opinion
27 May 2016
REC opinion
Further Information Favourable Opinion