Ultrasonographic evaluation of normal extrinsic and intrinsic carpal ligaments: preliminary experience.
OBJECTIVE
To determine normal anatomy of extrinsic and intrinsic carpal ligaments at ultrasonography (US).


METHODS
In the first part of the study, two musculoskeletal radiologists retrospectively reviewed in consensus the photographs of anatomic sections and dissections derived from 20 cadaveric wrists. This cadaveric study gave the two readers the opportunity to learn the anatomy and orientation of the various extrinsic and intrinsic carpal ligaments and, thus, to develop a US protocol to facilitate the recognition of each carpal ligament. In the second part of the study, these two radiologists prospectively and independently evaluated the visibility of extrinsic and intrinsic carpal ligaments in 30 wrists of volunteers, using the same US protocol.


RESULTS
With regard to extrinsic carpal ligaments, the radioscaphocapitate ligament (partially visible, 38%; completely visible, 62%), the radiolunotriquetral ligament (partially visible, 27%; completely visible, 73%), the palmar ulnotriquetral ligament (partially visible, 12%; completely visible, 88%), and the dorsal radiotriquetral ligament (partially visible, 7%; completely visible, 93%) were visualized at US. The dorsal ulnotriquetral ligament (partially visible, 21%; completely visible, 74%), the ulnolunate ligament (partially visible, 5%; completely visible, 70%), and the radial collateral ligament (partially visible, 18%; completely visible, 12%) were more difficult to recognize. The radioscapholunate ligament was never seen. With regard to intrinsic carpal ligaments, the dorsal (partially visible, 11%; completely visible, 89%) and palmar (partially visible, 38%; completely visible, 62%) scaphotriquetral ligaments as well as the dorsal scapholunate ligament (partially visible, 3%; completely visible, 97%) were visualized at US. The dorsal lunotriquetral ligament (partially visible, 39%; completely visible, 61%) and the palmar scapholunate ligaments (partially visible, 12%; completely visible, 81%) were more difficult to recognize.


CONCLUSIONS
US may be helpful in identifying the major extrinsic and intrinsic carpal ligaments.
Boutry
Nathalie
N
Musculoskeletal Radiology Department, Hôpital Roger Salengro, CHRU de Lille, Boulevard du Pr. J Leclercq, 59037, Lille Cedex, France. nboutry@chru-lille.fr
Lapegue
Franck
F
Masi
Laetitia
L
Claret
Antoine
A
Demondion
Xavier
X
Cotten
Anne
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D002348:Carpal Bones / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008022:Ligaments / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D012189:Retrospective Studies; D014463:Ultrasonography; D014953:Wrist / Q000033:anatomy & histology / Q000000981:diagnostic imaging