Diagnostic accuracy of plain radiographs and cineradiography in diagnosing traumatic scapholunate dissociation

Pliefke, Jenny; Stengel, Dirk; Rademacher, G.; Mutze, Sven; Ekkernkamp, Axel; Eisenschenk, A.

doi:10.1007/s00256-007-0410-7

Cited by 72 publications

(68 citation statements)

References 36 publications

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“…3). However, this is also seen in a substantial number of normal wrists and will also be seen on inadequate PA views in which there is (even mild) radial deviation (Pliefke et al 2008). It has to be noted that the flexed position of the scaphoid and the extended position of the lunate is much more easily recognized on the lateral view.…”

Section: Type I Instabilitiesmentioning

confidence: 95%

“…Although the use of conventional PA and lateral radiographs is widely adopted, the value of additional views is questionable and debated in the literature and among clinicians. Several additional views (instability series and/or stress views) are described; PA views with maximal ulnar and maximal radial deviation, and AP clenched fist views are among the ones most commonly used (Gilula et al 2002;Peh and Gilula 1994;Weiss et al 2007;De Filippo et al 2006;Metz et al 1997;Pliefke et al 2008). In some cases up to 15 different additional views to analyze the wrist of a single patient are described (Metz et al 1997).…”

Section: Conventional Radiographymentioning

confidence: 96%

“…A study by Pliefke et al (2008) mentioned a sensitivity of 86 % with a specificity of 95 %. A study by Kwon and Baek 2008, using a cutoff point of a 2 mm scapho-lunate gap at fluoroscopy, mentioned a maximum sensitivity of 95 % (Kwon and Baek 2008).…”

Section: Cineradiographymentioning

confidence: 97%

See 2 more Smart Citations

Wrist Instability

Jonge¹,

Streekstra²,

Strackee³

et al. 2013

Medical Radiology

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Section: Type I Instabilitiesmentioning

confidence: 95%

Section: Conventional Radiographymentioning

confidence: 96%

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Wrist Instability

Jonge¹,

Streekstra²,

Strackee³

et al. 2013

Medical Radiology

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“…Various SL stress radiographic techniques have been advocated; however, there is no universally accepted best view. Several methods for measuring the SL interval have been reported with abnormal values ranging from 2 to 4 mm [19,22]. We adopted the mid-interval SL measurement technique described by Lee et al [14], and we defined an abnormal gap in our static SL instability cases as 3 mm or greater on a neutral PA x-ray view [2]: a threshold value commonly used in our clinical practices.…”

Section: Discussionmentioning

confidence: 99%

“…Dynamic SL interval instability represents an injury primarily to the SL ligament and may require stress x-ray imaging for diagnostic confirmation [12,19]. Static SL interval instability, in the absence of bone injury and/or joint deformity, results from damage to both the SL ligament and secondary soft tissue restraints and will often be evident on routine posteroanterior (PA) and lateral x-ray projections [3,17,23].…”

Section: Introductionmentioning

confidence: 99%

Comparisons of Three Radiographic Views in Assessing for Scapholunate Instability

Patel

Kalainov

Chilelli

et al. 2014

Hand (New York, N,Y.)

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Background Multiple wrist x-ray images have been described to assess for scapholunate (SL) instability. Some views may be redundant. The purpose of this study was to compare three plain x-ray views in identifying a traumatic diastasis of the SL interval. Methods Nineteen patients (19 wrists) with a positive scaphoid shift test and surgically confirmed SL ligament damage were identified. There were 15 males and 4 females with a mean age of 39 years. Pre-operative x-rays were reviewed, including posteroanterior (PA) neutral and PA ulnar deviation views of the injured wrist, and PA clenched fist views of the injured and uninjured wrists. Dynamic SL instability was defined by an SL mid-interval gap of <3 mm and static SL instability by a gap of ≥3 mm in the PA neutral views. The mid-interval measurements were compared between x-ray images. Results There were 10 dynamic and 9 static SL instability cases. The PA ulnar deviation and the PA clenched fist views showed significantly greater SL gaps in comparison to the PA neutral views in dynamic but not static SL instability cases. In both categories of instability, there was no significant difference in the SL gaps between the two stress images. The PA clenched fist view of the uninjured wrist revealed SL gapping of >3 mm in 50% of patients but with generally greater gapping in the clenched fist view of the injured wrist. Conclusions The PA ulnar deviation and clenched fist stress views were equally effective in showing a dynamic SL diastasis following wrist injury. Neither view was more effective than a neutral PA view in diagnosing static SL instability.

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Hand examination and investigations

Coert

Hoogvliet

Rinkel

2015

Plastic and Reconstructive Surgery

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CHapter 48The medical student adage of 'look, feel and move' applies to hand examination at all clinical levels. Having been put in harm's way more than any other part of the body, this extension of our mental will into the external world doubles up as a tactile organ as well. A thorough knowledge of its anatomy and biomechanical principles assists the clinician in narrowing down the pathology. Recognition of patterns of pathology and injury are as important in examining the hands as they are in any other form of clinical examination.

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Diagnostic accuracy of plain radiographs and cineradiography in diagnosing traumatic scapholunate dissociation

Cited by 72 publications

References 36 publications

Wrist Instability

Wrist Instability

Comparisons of Three Radiographic Views in Assessing for Scapholunate Instability

Hand examination and investigations

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