Published online Apr 30, 2007.
https://doi.org/10.4055/jkoa.2007.42.2.171
Value of Post-arthrography Computed Tomography in Wrist Ligament Injuries
Abstract
Purpose
To evaluate the use of post-arthrography computed tomography in examining wrist ligament injuries.
Materials and Methods
Thirty consecutive patients who had a history and clinical findings suggestive of ligamentous injuries of the wrist were examined. Fourteen men and sixteen women (average age 35 years) were enrolled in this study. The evaluation concentrated on the detection and precise localization of the ligament lesions in the triangular fibrocartilage (TFC), the scapholunate ligament (SLL) and the lunotriquetral ligament (LTL).
Results
For TFC, SLL and LTL lesions, arthro-CT showed a sensitivity 96%, 90% and 85.7%, and a specificity 80%, 90% and 91.3%, and an accuracy 93.3%, 90% and 93.3%, respectively.
Conclusion
Arthro-CT may be a useful imaging method for evaluating intra-articular ligament injuries of the wrist.
Fig. 1
(A) A 24-year old women with ulnar sided wrist pain on the left side. Coronal reformatted Arthro-CT shows a tear of TFC radial attachment. (B) Arthroscopy shows the radial tear of the TFC.
Fig. 2
(A) A 29-year old man with a painful wrist on the right side. Arthro-CT shows dye filling between the lunate and scaphoid bones. (B) Arthroscopy shows inferior perforation of the scapholunate interosseous ligament.
Table 1
Palmer's Classification of Tiangular Fibrocarilage (TFC) Lesions
Table 2
Triangular Fibrocartilage (TFC) Radiology Findings
Table 3
Scapolunate Ligament Radiology Findings
Table 4
Lunotriquetral Ligament Radiology Findings
References
-
Bednar JM, Osterman AL. The role of arthroscopy in the treatment of traumatic fibrocartilage injuries. Hand Clin 1994;10:605–614.
-
-
Dailey SW, Palmer AK. The role of arthroscopy in the evaluation and treatment of triangular fibrocartilage complex injuries in athletes. Hand Clin 2000;16:461–476.
-
-
Mayfield JK. Patterns of injury to carpal ligaments. A spectrum. Clin Orthop Relat Res 1984;187:36–42.
-
-
Oneson SR, Timins ME, Scales LM, Erikson SJ, Chamoy L. MR imaging diagnosis of triangular fibrocartilage pathology with arthroscopic correlation. AJR Am J Roentgenol 1997;168:1513–1518.
-
-
Schweitzer ME, Brahme SK, Hodler J, et al. Chronic wrist pain: spin-echo and short tau inversion recovery MR imaging and conventional and MR arthrography. Radiology 1992;182:205–211.
-
-
Taleisnick J. The ligaments of the wrist. J Hand Surg Am 1976;1:110–118.
-
-
Weiss AP, Akelman E, Lambiase R. Comparison of the findings of triple-injection cinearthrography of the wrist with those of arthroscopy. J Bone Jont Surg Am 1996;78:348–356.
-
-
Whipple TL, Geissler WB. Arthroscopic management of wrist triangular fibrocartilage complex injuries in the athlete. Orthopedics 1993;16:1061–1067.
-