title: Advanced imaging of the scapholunate ligamentous complex.
abstract: The scapholunate joint is one of the most involved in wrist injuries. Its stability depends on primary and secondary stabilisers forming together the scapholunate complex. This ligamentous complex is often evaluated by wrist arthroscopy. To avoid surgery as diagnostic procedure, optimization of MR imaging parameters as use of three-dimensional (3D) sequences with very thin slices and high spatial resolution, is needed to detect lesions of the intrinsic and extrinsic ligaments of the scapholunate complex. The paper reviews the literature on imaging of radial-sided carpal ligaments with advanced computed tomographic arthrography (CTA) and magnetic resonance arthrography (MRA) to evaluate the scapholunate complex. Anatomy and pathology of the ligamentous complex are described and illustrated with CTA, MRA and corresponding arthroscopy. Sprains, mid-substance tears, avulsions and fibrous infiltrations of carpal ligaments could be identified on CTA and MRA images using 3D fat-saturated PD and 3D DESS (dual echo with steady-state precession) sequences with 0.5-mm-thick slices. Imaging signs of scapholunate complex pathology include: discontinuity, nonvisualization, changes in signal intensity, contrast extravasation (MRA), contour irregularity and waviness and periligamentous infiltration by edema, granulation tissue or fibrosis. Based on this preliminary experience, we believe that 3 T MRA using 3D sequences with 0.5-mm-thick slices and multiplanar reconstructions is capable to evaluate the scapholunate complex and could help to reduce the number of diagnostic arthroscopies.
authors.affiliation: Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium. maryam.shahabpour@uzbrussel.be.
authors.forename: Maryam
authors.initials: M
authors.lastname: Shahabpour
authors.affiliation: Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium. barbarastaelens@hotmail.com.
authors.forename: Barbara
authors.initials: B
authors.lastname: Staelens
authors.affiliation: Hand and Foot Surgery Unit (HFSU), Tournai, Belgium. l.v.o@skynet.be.
authors.forename: Luc
authors.initials: L
authors.lastname: Van Overstraeten
authors.affiliation: Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium. michel.demaeseneer@uzbrussel.be.
authors.forename: Michel
authors.initials: M
authors.lastname: De Maeseneer
authors.affiliation: Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium. cedric.boulet@uzbrussel.be.
authors.forename: Cedric
authors.initials: C
authors.lastname: Boulet
authors.affiliation: Department of Radiology, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090, Brussels, Belgium. johan.demey@uzbrussel.be.
authors.forename: Johan
authors.initials: J
authors.lastname: De Mey
authors.affiliation: Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium. thierry.scheerlinck@uzbrussel.be.
authors.forename: Thierry
authors.initials: T
authors.lastname: Scheerlinck
mesh_terms: D001175:Arthrography / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007593:Joint Instability / Q000175:diagnosis*; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D012667:Lunate Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015203:Reproducibility of Results; D021361:Scaphoid Bone / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014954:Wrist Injuries / Q000175:diagnosis*
keywords: CT arthrography; Imaging; MR arthrography; Scapholunate ligament complex; Wrist arthroscopy