Abstract:The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The p… Show more
“…The scapholunate ligament complex comprises not only the intrinsic SL ligament (with dorsal and palmar bands) but also the extrinsic palmar RC ligaments: radioscaphocapitate (RSC), long radiolunate (LRL), short radiolunate (SRL), and the intrinsic midcarpal scaphotrapeziotrapezoid (STT) ligament complex at the palmar side. It also includes the extrinsic dorsal radiocarpal (DRC) ligament, the DIC ligament, and the dorsal capsular scapholunate septum (DCSS) at the dorsal side [14][15][16][17] (►Table 1).…”
Section: Scapholunate Ligament Complexmentioning
confidence: 99%
“…In chronic injury, the SL ligament can present an abnormal morphology with fraying, thinning, or periligamentous infiltration by granulation or scar tissue (enhancing on intravenous MRI) and focal increased signal intensity on proton-density (PD) or T2 sequences. 15 Specific secondary MR imaging findings that correlate with a tear include widening of the intercarpal space or split-cartilage sign, focal osseous offset or incongruous joint, carpal arc disruption, associated ganglion cyst, or focal chondromalacia/osteoarthritis. However, these secondary signs often have poor interobserver consistency and low sensitivity.…”
Section: Scapholunate Ligament Complexmentioning
confidence: 99%
“…However, these secondary signs often have poor interobserver consistency and low sensitivity. 4,15,26 According to different correlation studies, MRI and MRA show a high diagnostic value for the detection of SL ligament tears with MRA much better than plain MRI. The metaanalysis of Hafezi-Nejad et al for the detection of an SL ligament injury determined a sensitivity of 76% and a specificity of 97% for 3-T MRI and a sensitivity of 82% and a specificity of 93% for 3-T MRA.…”
Section: Scapholunate Ligament Complexmentioning
confidence: 99%
“…Rominger et al observed a dark ligament-like structure connecting the palmar aspect of the radius with the scaphoid and the lunate in 65% of cases. 15,24 Pathology (of RSC and LRL): The study of Taneja et al on the prevalence of extrinsic ligament injury determined by MRI and its association with intrinsic ligament tears revealed that the most frequently injured extrinsic ligaments are the LRL, RSC, and dorsal radiotriquetral (DRT). 41 They found a high prevalence of extrinsic ligament injury in the setting of acute wrist trauma, especially sprain and partial tears, in the presence or absence of fractures or bone contusions.…”
Carpal stability depends on the integrity of both intra-articular and intracapsular carpal ligaments. In this review, the role of the radial-sided and ulnar-sided extrinsic and intrinsic ligaments is described, as well as their advanced imaging using magnetic resonance arthrography (MRA) and contrast-enhanced magnetic resonance imaging (MRI) with three-dimensional (3D) scapholunate complex sequences and thin slices. In the last decade, the new concept of a so-called “scapholunate complex” has emerged among hand surgeons, just as the triangular ligament became known as the triangular fibrocartilage complex (TFCC).The scapholunate ligament complex comprises the intrinsic scapholunate (SL), the extrinsic palmar radiocarpal: radioscaphocapitate (RSC), long radiolunate (LRL), short radiolunate (SRL) ligaments, the extrinsic dorsal radiocarpal (DRC) ligament, the dorsal intercarpal (DIC) ligament, as well as the dorsal capsular scapholunate septum (DCSS), a more recently described anatomical structure, and the intrinsic palmar midcarpal scaphotrapeziotrapezoid (STT) ligament complex. The scapholunate (SL) ligament complex is one of the most involved in wrist injuries. Its stability depends on primary (SL ligament) and secondary (RSC, DRC, DIC, STT ligaments) stabilizers.The gold standard for carpal ligament assessment is still diagnostic arthroscopy for many hand surgeons. To avoid surgery as a diagnostic procedure, advanced MRI is needed to detect associated lesions (sprains, midsubstance tears, avulsions and chronic fibrous infiltrations) of the extrinsic, midcarpal and intrinsic wrist ligaments, which are demonstrated in this article using 3D and two-dimensional sequences with thin slices (0.4 and 2 mm thick, respectively).
“…The scapholunate ligament complex comprises not only the intrinsic SL ligament (with dorsal and palmar bands) but also the extrinsic palmar RC ligaments: radioscaphocapitate (RSC), long radiolunate (LRL), short radiolunate (SRL), and the intrinsic midcarpal scaphotrapeziotrapezoid (STT) ligament complex at the palmar side. It also includes the extrinsic dorsal radiocarpal (DRC) ligament, the DIC ligament, and the dorsal capsular scapholunate septum (DCSS) at the dorsal side [14][15][16][17] (►Table 1).…”
Section: Scapholunate Ligament Complexmentioning
confidence: 99%
“…In chronic injury, the SL ligament can present an abnormal morphology with fraying, thinning, or periligamentous infiltration by granulation or scar tissue (enhancing on intravenous MRI) and focal increased signal intensity on proton-density (PD) or T2 sequences. 15 Specific secondary MR imaging findings that correlate with a tear include widening of the intercarpal space or split-cartilage sign, focal osseous offset or incongruous joint, carpal arc disruption, associated ganglion cyst, or focal chondromalacia/osteoarthritis. However, these secondary signs often have poor interobserver consistency and low sensitivity.…”
Section: Scapholunate Ligament Complexmentioning
confidence: 99%
“…However, these secondary signs often have poor interobserver consistency and low sensitivity. 4,15,26 According to different correlation studies, MRI and MRA show a high diagnostic value for the detection of SL ligament tears with MRA much better than plain MRI. The metaanalysis of Hafezi-Nejad et al for the detection of an SL ligament injury determined a sensitivity of 76% and a specificity of 97% for 3-T MRI and a sensitivity of 82% and a specificity of 93% for 3-T MRA.…”
Section: Scapholunate Ligament Complexmentioning
confidence: 99%
“…Rominger et al observed a dark ligament-like structure connecting the palmar aspect of the radius with the scaphoid and the lunate in 65% of cases. 15,24 Pathology (of RSC and LRL): The study of Taneja et al on the prevalence of extrinsic ligament injury determined by MRI and its association with intrinsic ligament tears revealed that the most frequently injured extrinsic ligaments are the LRL, RSC, and dorsal radiotriquetral (DRT). 41 They found a high prevalence of extrinsic ligament injury in the setting of acute wrist trauma, especially sprain and partial tears, in the presence or absence of fractures or bone contusions.…”
Carpal stability depends on the integrity of both intra-articular and intracapsular carpal ligaments. In this review, the role of the radial-sided and ulnar-sided extrinsic and intrinsic ligaments is described, as well as their advanced imaging using magnetic resonance arthrography (MRA) and contrast-enhanced magnetic resonance imaging (MRI) with three-dimensional (3D) scapholunate complex sequences and thin slices. In the last decade, the new concept of a so-called “scapholunate complex” has emerged among hand surgeons, just as the triangular ligament became known as the triangular fibrocartilage complex (TFCC).The scapholunate ligament complex comprises the intrinsic scapholunate (SL), the extrinsic palmar radiocarpal: radioscaphocapitate (RSC), long radiolunate (LRL), short radiolunate (SRL) ligaments, the extrinsic dorsal radiocarpal (DRC) ligament, the dorsal intercarpal (DIC) ligament, as well as the dorsal capsular scapholunate septum (DCSS), a more recently described anatomical structure, and the intrinsic palmar midcarpal scaphotrapeziotrapezoid (STT) ligament complex. The scapholunate (SL) ligament complex is one of the most involved in wrist injuries. Its stability depends on primary (SL ligament) and secondary (RSC, DRC, DIC, STT ligaments) stabilizers.The gold standard for carpal ligament assessment is still diagnostic arthroscopy for many hand surgeons. To avoid surgery as a diagnostic procedure, advanced MRI is needed to detect associated lesions (sprains, midsubstance tears, avulsions and chronic fibrous infiltrations) of the extrinsic, midcarpal and intrinsic wrist ligaments, which are demonstrated in this article using 3D and two-dimensional sequences with thin slices (0.4 and 2 mm thick, respectively).
“…Chronic tears may demonstrate a static SL gap on the PA film and an increased SL angle on the lateral consistent with dorsal intercalated segmental instability (DISI). Advanced imaging is commonly needed in the form of MRI with or without contrast arthrography [ 14 ]. Fig.…”
BackgroundHand and wrist injuries are common during athletics and can have a significant impact especially if initially disregarded. Due to their high level of physical demand, athletes represent a unique subset of the population.Main bodyThe following is an overview of hand and wrist injuries commonly seen in athletics. Information regarding evaluation, diagnosis, conservative measures, and surgical treatment are provided.ConclusionKnowledge of these entities and special consideration for the athlete can help the team physician effectively treat these players and help them achieve their goals.
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