What is the initial imaging method recommended for evaluating a scaphoid injury?

The initial imaging method recommended for evaluating a scaphoid injury is X-ray. X-rays are readily available, quick, and cost-effective, making them the first-line imaging modality for assessing potential fractures, including those of the scaphoid bone. Scaphoid injuries can be subtle, and standard X-rays often miss fractures in the early stages; however, they are still the preferred initial approach.

X-rays can provide essential information about the alignment and integrity of the wrist. If an initial X-ray does not show any fractures but there is clinical suspicion—such as tenderness in the anatomical snuffbox—further imaging may then be warranted to rule out a fracture, as healing concerns exist with scaphoid injuries due to their unique blood supply.

Other imaging modalities, like MRI and CT, can provide more sensitive detection of occult fractures or aid in assessing for complications, but they are typically reserved for cases where the X-ray findings are inconclusive and the suspicion for a fracture remains high. Bone scans have a broader application and are not specifically targeted for the acute evaluation of scaphoid injuries, making them less effective as an initial imaging choice. Thus, X-ray remains the foundational first step in diagnosing a suspected scaphoid injury.