title: The diagnostic accuracy of wrist cineradiography in diagnosing scapholunate dissociation.
abstract: Ruptures of the scapholunate ligament (SLL) may cause carpal instability, also known as scapholunate dissociation (SLD). SLD may lead to osteoarthritis of the radiocarpal and midcarpal joints. The aim of this retrospective study was to determine the diagnostic value of wrist cineradiography in detecting SLD. All cineradiographic studies made during a 24 year period were retrieved. All patients who underwent the confirmation method (arthroscopy and/or arthrotomy) and cineradiography were included. In total, 84 patients met the inclusion criteria. Sensitivity, specificity, likelihood ratio, positive predictive value, negative predictive value, and diagnostic accuracy for detecting SLD were calculated for radiography and cineradiography. Cineradiography had a sensitivity of 90%, a specificity of 97%, and a diagnostic accuracy of 0.93 in detecting SLD. Radiography had a sensitivity of 81%, a specificity of 80%, and a diagnostic accuracy of 0.81. Cineradiography has a high diagnostic value for diagnosing SLDs. A positive cineradiography markedly increases the post-test probability of SLD.
authors.affiliation: 1Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: G S I
authors.initials: GS
authors.lastname: Sulkers
authors.forename: N W L
authors.initials: NW
authors.lastname: Schep
authors.forename: M
authors.initials: M
authors.lastname: Maas
authors.forename: C M A M
authors.initials: CM
authors.lastname: van der Horst
authors.forename: J C
authors.initials: JC
authors.lastname: Goslings
authors.forename: S D
authors.initials: SD
authors.lastname: Strackee
mesh_terms: D002933:Cineradiography; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging*; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries; D012667:Lunate Bone / Q000000981:diagnostic imaging; D021361:Scaphoid Bone / Q000000981:diagnostic imaging; D014954:Wrist Injuries / Q000000981:diagnostic imaging*; D014955:Wrist Joint / Q000000981:diagnostic imaging*
keywords: Fluoroscopy; scapholunate dissociation; scapholunate ligament; wrist arthroscopy; wrist cineradiography