title: Evaluation of selective wrist arthrography of contralateral asymptomatic wrists for symmetric ligamentous defects.
abstract: OBJECTIVE
  The objective of this investigation was to study the role of selective wrist arthrography of the asymptomatic wrists of patients with unilateral wrist pain and the efficacy of three-compartment and selective-compartment injections of contrast medium into the asymptomatic wrist in demonstrating symmetric and asymmetric intercarpal ligament and triangular fibrocartilage communicating defects.
  
  
  METHODS
  Wrist arthrography with bilateral three-compartment injections was performed for 62 patients with unilateral wrist pain. The numbers of bilateral intercarpal ligament and triangular fibrocartilage communicating defects were recorded. The results obtained with three-compartment injections in each wrist of these patients were compared with those obtained with single-compartment injections.
  
  
  RESULTS
  Bilateral three-compartment injections identified 110 communicating defects (59 in the symptomatic and 51 in the asymptomatic wrists). Midcarpal injections showed all 36 scapholunate and lunatotriquetral ligament defects that were also shown by three-compartment injections in asymptomatic wrists. However, only 26 (72%) of these 36 ligament defects were shown by radiocarpal injections. No single-compartment injection showed all triangular fibrocartilage defects that were shown by three-compartment injections. Ten bilateral symmetric triangular fibrocartilage communicating defects were shown by three-compartment injections. All 10 triangular fibrocartilage communicating defects in asymptomatic wrists were shown by radiocarpal injections. However, only five of the 10 triangular fibrocartilage communicating defects in asymptomatic wrists were shown by injection of the distal radioulnar joints.
  
  
  CONCLUSIONS
  Selective midcarpal injection of an asymptomatic wrist showed all matching defects in that wrist when only intercarpal ligament defects were found in the symptomatic wrist. Similarly, selective radiocarpal injection of an asymptomatic wrist showed all matching defects of the triangular fibrocartilage in that wrist. In either situation, routine injection of all three compartments of the asymptomatic wrist should not be necessary.
authors.affiliation: Beijing Ji Shui Tan Hospital, Beijing Institute of Traumatology and Orthopaedics, People's Republic of China.
authors.forename: Y M
authors.initials: YM
authors.lastname: Yin
authors.forename: B
authors.initials: B
authors.lastname: Evanoff
authors.forename: L A
authors.initials: LA
authors.lastname: Gilula
authors.forename: T K
authors.initials: TK
authors.lastname: Pilgram
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018771:Arthralgia / Q000000981:diagnostic imaging; D001175:Arthrography / Q000295:instrumentation / Q000379:methods; D002358:Cartilage, Articular / Q000000981:diagnostic imaging; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007482:Iothalamate Meglumine / Q000008:administration & dosage; D008023:Ligaments, Articular / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D014955:Wrist Joint / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D007482:Iothalamate Meglumine