Radiocarpal Injuries: Cone Beam Computed Tomography Arthrography, Magnetic Resonance Arthrography, and Arthroscopic Correlation among 21 Patients

Suojärvi, Nora; Haapamäki, Ville; Lindfors, Nina; Koskinen, Seppo

doi:10.1177/1457496916659226

Cited by 10 publications

(7 citation statements)

References 17 publications

(25 reference statements)

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“… 26 31 Two studies used cone-beam CT (CBCT) as index for diagnosing TFCC lesions. 37 42 In 12 studies, MRI was used as an index test. 23–25 27 30 32–35 37 40 41 The accuracy of MRI for TFCC, SLIL, LTIL and ulnotriquetral interosseous ligament (UTIL) lesions with high-resolution (3 T) techniques ranging from 89% to 91%, 75% to 92%, 91% and 100%, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…In the current review, five studies used another imaging tool, namely, radiograph, 36 US 26 31 and CBCT 37 42 for diagnosing non-chronic ligament and tendon injuries of the wrist. The diagnostic accuracy of radiograph was limited.…”

Section: Discussionmentioning

confidence: 99%

“…Eight studies were retrospective [23][24][25][26][27][28][29][30] nine studies were prospective [31][32][33][34][35][36][37][38][39] and six studies [40][41][42][43][44][45] gave no description of the study design. Eight studies 23 25 27 31 33 36 43 45 included more than 60 participants; six of these studies 23 25 27 31 33 36 described wrist pathologies and two 43 45 described hand pathologies.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update

et al. 2020

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ObjectiveThe diagnostic work-up for ligament and tendon injuries of the finger, hand and wrist consists of history taking, physical examination and imaging if needed, but the supporting evidence is limited. The main purpose of this study was to systematically update the literature for studies on the diagnostic accuracy of tests for detecting non-chronic ligament and tendon injuries of the finger, hand and wrist.MethodsMedline, Embase, Cochrane Library, Web of Science, Google Scholar ProQuest and Cinahl were searched from 2000 up to 6 February 2019 for identifying studies. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist, and sensitivity (Se), specificity (Sp), accuracy, positive predictive value (PPV) and negative predictive value (NPV) were extracted.ResultsNone of the studies involved history taking. Physical examination, for diagnosing lesions of the triangular fibrocartilage complex (TFCC), showed Se, Sp, accuracy, PPV and NPV ranging from 58% to 90%, 20% to 69%, 56% to 73%, 53% to 71% and 55% to 65%, respectively. Physical examination in hand and finger injuries the Se, Sp, accuracy, PPV and NPV ranged from 88% to 99%, 75% to 100%, 34% to 88%, 91% to 100% and 75% to 95%, respectively. The accuracy of MRI with high-resolution (3 T) techniques for TFCC and interosseous ligaments of the proximal carpal row ranged from 89% to 91% and 75% to 100%, respectively. The accuracy of MRI with low-resolution (1.5 T) techniques for TFCC and interosseous ligaments of the proximal carpal row ranged from 81% to 100% and 67% to 95%, respectively.ConclusionsThere is limited evidence on the diagnostic accuracy of history taking and physical examination for non-chronic finger, hand and wrist ligament and tendon injuries. Although some imaging modalities seemed to be acceptable for the diagnosis of ligament and tendon injuries in the wrist in patients presenting to secondary care, there is no evidence-based advise possible for the diagnosis of non-chronic finger, hand or wrist ligament and tendon injuries in primary care.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update

et al. 2020

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“…CBCT arthrograms 22 have been shown to have a slightly higher specificity than magnetic resonance arthrography. The sensitivity of CBCT arthrography is also better for cartilage lesions, except for those on the chondral surface of the lunate, according to Suojärvi et al 23 Suojärvi et al showed that 10/21 patients with wrist pain had cartilage injuries (47, 6%), indicating that cartilage injuries may be far more prevalent than previously documented. On regular radiographs, minor triquetral or ulnar-sided lunate sclerosis or cyst formation may be signs of ulnocarpal wear.…”

Section: Diagnosis and Evaluationmentioning

confidence: 94%

Cartilage Injuries and Posttraumatic Osteoarthritis in the Wrist: A Review

2021

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Objective: Focal cartilage injuries, and posttraumatic osteoarthritis (OA) in the wrist are likely common and a cause of wrist pain. To estimate the incidence of cartilage lesions and to understand the pathomechanisms leading to wrist cartilage injuries and OA, a literature review on the subject was performed combined with a presentation of one of the authors’ own experience. Design: This study includes a literature review of the topic. As a comparison to the review findings, the observations of one of the authors’ consecutive 48 wrist arthroscopies, were assessed. PubMed, Scholar, and Cochrane databases were searched using the keywords “cartilage injury AND wrist AND treatment” and “wrist AND cartilage AND chondral AND osteochondral AND degenerative OA.” :Result A total of 11 articles, including 9 concerning chondral and osteochondral repair and treatment and 2 regarding posttraumatic OA, were retrieved. The cartilage repair treatments used in these articles were drilling, osteochondral autograft, juvenile articular cartilage allograft, and chondrocyte implantation. One article displayed concomitant cartilage injuries in displaced distal radius fractures in 32% of the patients. The review of our findings from a 1-year cohort of wrist arthroscopies showed 17% cartilage injuries. Conclusion: There is a lack of knowledge in current literature on cartilage injuries and treatment, as well as posttraumatic OA in the wrist. Cartilage injuries appear to be common, being found in 17% to 32% of all wrist arthroscopies after trauma, but no guidelines regarding conservative or surgical treatment can be recommended at the moment. Larger prospective comparative studies are needed.

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“…In contrast, palmar-flexed intercalated segment instability (PISI) is present with flexion of the lunate to palmar. This rather rare finding can be seen in midcarpal instability and lunotriquetral dissociation [17,28]. The acronyms "DISI" and "PISI" are descriptions for the pathological arrangement of the lunate in the central carpal column, but do not describe independent clinical conditions.…”

Section: Dissociative Carpal Instabilities (Cid)mentioning

confidence: 99%

Imaging of Carpal Instabilities

Grunz

Gietzen

Grunz

et al. 2020

Rofo

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Background The term “carpal instability” describes different debilitating wrist conditions, in which the carpus is unable to maintain its physiological range of motion and load transfer. Depending on the cause and location of the dysfunction, four groups can be defined: dissociative, non-dissociative, complex, and adaptive carpal instability. As the most common form by far, dissociative carpal instability can further be categorized as dorsal or palmar intercalated segment instability, contingent on the afflicted interosseous ligament. Method This review article outlines the different entities of carpal instability, their pathophysiology, and their clinical presentation. It further discusses the diagnostic significance of different imaging methods as well as the established treatment options for each form of instability in context with the current literature. Results and Conclusion Early detection and treatment of carpal instability are essential for preventing carpal osteoarthritis. Traumatic lesions of the scapholunate interosseous ligament are the most frequent cause of instability. They can occur in an isolated fashion or in context with other carpal injuries. While stress imaging and fluoroscopy facilitate the differentiation between dynamic and static forms of carpal instability, only MRI and CT/MR arthrography can directly reveal the extent of ligament discontinuity. Key Points: Citation Format

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Radiocarpal Injuries: Cone Beam Computed Tomography Arthrography, Magnetic Resonance Arthrography, and Arthroscopic Correlation among 21 Patients

Cited by 10 publications

References 17 publications

Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update

Diagnostic accuracy of history taking, physical examination and imaging for non-chronic finger, hand and wrist ligament and tendon injuries: a systematic review update

Cartilage Injuries and Posttraumatic Osteoarthritis in the Wrist: A Review

Imaging of Carpal Instabilities

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