When should I refer a patient with a suspected scaphoid fracture to secondary care for further evaluation?

Refer a patient with a suspected scaphoid fracture to secondary care for further evaluation if clinical examination suggests a scaphoid injury despite normal initial X-rays. Consider MRI as a first-line imaging modality in secondary care to confirm the diagnosis following thorough clinical assessment.

Early referral is important because scaphoid fractures can be occult on initial X-rays and require specialist imaging and management to prevent complications.