HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text All Versions of this Article: 2383050013v1 238/3/950    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Theumann, N. H. Articles by Gilula, L. A. Search for Related Content PubMed PubMed Citation Articles by Theumann, N. H. Articles by Gilula, L. A.

Association between Extrinsic and Intrinsic Carpal Ligament Injuries at MR Arthrography and Carpal Instability at Radiography: Initial Observations¹

¹ From the Department of Radiology (N.H.T., G.E., B.D., P.S.) and Department of Plastic Surgery and Hand Surgery (N.F.), Centre Hospitalier Universitaire Vaudois, rue du Bugnon 46, 1011 Lausanne, Switzerland; Department of Radiology, University of California, San Francisco, Calif (M.W.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (L.A.G.). Received January 5, 2005; revision requested March 10; revision received April 22; accepted June 2; final version accepted August 1. Address correspondence to N.H.T. (e-mail: Nicolas.Theumann{at}chuv.ch).

Purpose: To retrospectively compare the presence or absence of carpal instability on radiographs with the findings of magnetic resonance (MR) arthrographic evaluation of intrinsic and extrinsic ligament tears in patients with chronic wrist pain.

Materials and Methods: The institutional review board approved this study and did not require informed consent. Signs of carpal instability were assessed on static and dynamic radiographs of the wrist obtained in 72 patients (24 female, 48 male; mean age, 36 years; age range, 14–59 years) with posttraumatic wrist pain. MR arthrography was subsequently performed. Two musculoskeletal radiologists independently analyzed the radiographs and MR images. Each intrinsic and extrinsic ligament was individually evaluated for the presence of a ligament tear. The extent of the tear also was recorded. Interobserver agreement regarding MR arthrographic findings was tested by calculating statistics. Statistical comparison between radiography and MR arthrography was performed by using the Fisher exact test.

Results: Twenty-five triangular fibrocartilage complex, 18 (five partial, 13 complete) scapholunate ligament, and 25 (10 partial, 15 complete) lunotriquetral ligament tears were visualized. Twenty-two (all complete) extrinsic ligament tears were detected: two radial collateral ligament, 10 radioscaphocapitate ligament, and 10 radiolunotriquetral ligament tears. Interobserver agreement regarding intrinsic and extrinsic ligament tear detection at MR arthrography was excellent ( = 0.80). Nineteen patients had evidence of carpal instability on radiographs. Fourteen (52%) of 27 patients with at least one complete intrinsic lesion had no sign of carpal instability. On the other hand, the association of scapholunate ligament and/or lunotriquetral ligament and extrinsic ligament tears was significantly correlated (P < .001) with carpal instability at radiography.

Conclusion: The presence or absence of carpal instability on radiographs depends on the association between intrinsic and extrinsic ligament tears—even partial ones—rather than on the presence of intrinsic ligament tears alone, even when the tears are complete.

© RSNA, 2006

This article has been cited by other articles:

				T. Moser, J.-C. Dosch, A. Moussaoui, X. Buy, A. Gangi, and J.-L. Dietemann Multidetector CT Arthrography of the Wrist Joint: How to Do It RadioGraphics, May 1, 2008; 28(3): 787 - 800. [Abstract] [Full Text] [PDF]