Intraobserver and Interobserver Variability in Diagnosing Scapholunate Dissociation by Cineradiography

Sulkers, George S.I.; Schep, N.W.L.; Maas, Mario; Strackee, Simon D.

doi:10.1016/j.jhsa.2014.03.014

Cited by 7 publications

(7 citation statements)

References 22 publications

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“…With its sensitivity of 85%–90% and specificity of 90%–97%, wrist cineradiography has been shown to be a good modality for diagnosing SLDs ( Langner et al, 2015 ; Pliefke et al, 2008 ; Sulkers et al, 2014a ). Additionally, using a score sheet (Appendix 2), a recent study showed excellent inter-observer correlations (κ = 0.84) and good to excellent intra-observer correlations (κ = 0.72–0.80) ( Sulkers et al, 2014b ).…”

Section: Discussionmentioning

confidence: 99%

Wrist cineradiography: a protocol for diagnosing carpal instability

Sulkers

Strackee

Schep

et al. 2017

J Hand Surg Eur Vol

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Carpal instability is often related to ruptured or lax carpal ligaments. Wrist cineradiography has been shown to be a good modality for diagnosing carpal instability. To create uniformity in obtaining and assessing wrist cineradiography, a wrist cineradiography protocol is desirable. This protocol will focus on wrist cineradiography for diagnosing carpal instabilities. It describes the pathologic motions of the carpus and correlates these with a clinical diagnosis.Level of evidence: III

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Section: Discussionmentioning

confidence: 99%

Wrist cineradiography: a protocol for diagnosing carpal instability

Sulkers

Strackee

Schep

et al. 2017

J Hand Surg Eur Vol

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“…All ligaments surrounding the scaphoid were sectioned in their study. Since cadaveric testing will not predictably simulate in vivo kinematics, and because cineradiography may not be readily available in all physician practices [24, 25], we sought to assess the effectiveness of the PA ulnar deviation and the PA clenched fist views in depicting SL diastases in patients with surgically confirmed SL ligament damage. An increase in SL joint spacing was depicted in all dynamic SL instability cases using either stress x-ray image.…”

Section: Discussionmentioning

confidence: 99%

“…Lee et al [14] performed a cadaveric study to evaluate eight different stress x-ray views and determined that the PA clenched pencil view was the most effective in showing dynamic SL instability. Sulkers et al [24, 25] carried out two retrospective studies of patients suspected to have carpal instability and found cineradiography with the wrist in various positions useful in the diagnosis of SL dissociation. To our knowledge, there are no in vivo comparative studies of plain stress x-ray imaging in the assessment of SL instability.…”

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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“…A wide range of modalities has been described, from computed tomography (CT) to magnetic resonance imaging (MRI), MR-arthrogram (MRA) to cine-MRI, cine-fluoroscopy to 4D-CT [17][18][19]. MRI and MR-arthrograms are most commonly performed.…”

Section: Diagnosismentioning

confidence: 99%

Scapholunate and perilunate injuries in the athlete

Morrell

Moyer

Quinlan

et al. 2017

Curr Rev Musculoskelet Med

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Purpose of the review Scapholunate and perilunate injuries can be difficult to diagnose and treat in the athlete. In this review article, we present the mechanism of injury, evaluation, management, and outcomes of treatment for these injuries. Recent findings Acute repair of dynamic scapholunate ligament injuries remains the gold standard, but judicious use of a wrist splint can be considered for the elite athlete who is in season. The treatment of static scapholunate ligament injury remains controversial. Newer SL reconstructive techniques that aim to restore scapholunate function without compromising wrist mobility as much as tenodesis procedures show promise in athlete patients. Summary Acute injuries to the scapholunate ligament are best treated aggressively in order to prevent the sequelae of wrist arthritis associated with long-standing ligamentous injury. Acute repair is favored. Reconstructive surgical procedures to manage chronic scapholunate injury remain inferior to acute repair. The treatment of lunotriquetral ligament injuries is not well defined.

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Intraobserver and Interobserver Variability in Diagnosing Scapholunate Dissociation by Cineradiography

Cited by 7 publications

References 22 publications

Wrist cineradiography: a protocol for diagnosing carpal instability

Wrist cineradiography: a protocol for diagnosing carpal instability

Comparisons of Three Radiographic Views in Assessing for Scapholunate Instability

Scapholunate and perilunate injuries in the athlete

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