The distal radius, scaphoid, lunate, triquetrum, trapezium and hook of hamate have all been recognized as possible sites of fracture in the wrist, and their clinical presentation may somewhat vary. The diagnosis rests on the use of imaging studies guided by information obtained from patient history and physical examination.
Most important wrist fracture types and their respective clinical presentations are:
Patient history and findings observed during the physical examination are sufficient in turning the physician's attention to a wrist-related pathology, but imaging studies are necessary to confirm the presence of a fracture. Plain radiography of the injured wrist is an excellent initial method, but only if images are obtained in the adequate plane, depending on the site of injury . For example, scaphoid fractures require a lateral radiographic view, while distal radius fractures require both posteroanterior (PA) and lateral views, an external oblique projection and a PA image with ulnar deviation of the wrist . If the cause of symptoms is undisclosed with plain radiography, more sensitive imaging methods should be employed. Ultrasonography is recommended in the setting of suspected scaphoid fractures , but it is regarded as an inferior procedure compared to computed tomography (CT) and magnetic resonance imaging (MRI), described as the gold standard in imaging workup of the wrist  . These procedures can determine the exact site of fracture with great efficacy, and more importantly, determine the presence of other potential injuries (e.g., soft tissue injuries such as ligament tears or additional fractures) , which is why they are often recommended in early workup  . In some patients, technetium 99 (99 Te) bone scintigraphy may be used as a diagnostic tool .