Wrist arthrography after acute trauma to the distal radius: diagnostic accuracy, technique, and sources of diagnostic errors.
OBJECTIVE
The objective of this investigation was to determine the diagnostic accuracy of wrist arthrography in the detection of interosseous ligament disruptions and of triangular fibrocartilage complex (TFCC) lesions in patients after acute wrist trauma and to define the sources of diagnostic error of wrist arthrography after recent trauma.


METHODS
Twenty-two patients with radial fractures after acute wrist trauma underwent arthrography and arthroscopy of the wrist. Arthrography was performed in a standardized manner by two- or three-compartment injection technique. Subsequently wrist arthroscopy was performed within the same session. Image analysis included the evaluation of interosseous carpal ligaments, the TFCC, and the osseous structures.


RESULTS
In 22 patients, 11 injuries of the intrinsic ligaments and the TFCC were diagnosed by arthroscopy, of which 9 had been diagnosed correctly with arthrography before surgery. One scaphoid fracture previously missed on conventional radiographs also could be diagnosed by arthrography.


CONCLUSIONS
Arthrography of the posttraumatic wrist is a valuable tool in the diagnostic evaluation of interosseous carpal ligaments and the TFCC.
Grechenig
W
W
Department of Traumatology, Karl Franzens University of Graz, Medical School, Austria.
Peicha
G
G
Fellinger
M
M
Seibert
F J
FJ
Preidler
K W
KW
D000328:Adult; D001175:Arthrography / Q000379:methods*; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000293:injuries*; D003287:Contrast Media; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000628:therapy; D014954:Wrist Injuries / Q000000981:diagnostic imaging*; D014955:Wrist Joint / Q000000981:diagnostic imaging
D003287:Contrast Media