Abstract
Objective
The objective of this study was to evaluate ultrasound as a diagnostic tool for investigating scapholunate and lunatotriquetral ligamentous and triangular fibrocartilage (TFC) tears. Ultrasound findings were compared to conventional arthrogram findings, as the reference gold standard.
Design and patients
In total 26 patients, 17 males and 9 females ranging in age from 17 to 35 (mean age, 34), were evaluated on referral for investigation of wrist pain. All patients were examined by high resolution ultrasound, using a 9–13 MHz transducer. All wrist ultrasound examinations were also compared to conventional tricompartmental arthrography, as the diagnostic gold standard reference.
Results
All ten scapholunate tears confirmed on arthrography were detected on ultrasound. Two of 8 lunatotriquetral and 7 of 11 TFC tears were correctly diagnosed on ultrasound. Sensitivity of ultrasound diagnosis ranged from 25% for lunatotriquetral tears to 100% for scapholunate tears. No false positive results were recorded for any of the three examined structures.
Conclusion
The study results suggest that sonography is accurate for scapholunate tears, but is not accurate for evaluation of lunate-triquetral tears. It has intermediate accuracy for triangular fibrocartilage tears.
Similar content being viewed by others
References
Slater R, Szabo R, Bay B. Dorsal intercarpal ligament capsulodesis for scapholunate dissociation: biomechanical analysis in a cadaver model. J Hand Surg 1999; 224:232.
Griffith J, Chan D, Ho P, Zhao L, Hung L, Metreweli C. Sonography of the normal scapholunate ligament and scapholunate joint space. J Clinical Ultrasound 2001; 29:223–229.
Palmer A, Werner F. The triangular fibrocartilage complex of the wrist: anatomy and function. J Hand Surg 1981; 6:153.
Chiou HJ, Chang YH, Hsu CC. Triangular fibrocartilage of wrist: presentation on high resolution ultrasonography. J. Ultrasound Med 1998; 17:41–48.
Lee D. Wrist ultrasound unveils anatomic complexities. Joint Imaging 1996; Sept:19–30.
Bianchi S, Martinoli C, Abdelwahab IF. High-frequency ultrasound examination of the wrist and hand. Skeletal Radiol 1999; 28:121–129.
Jacobson J, Oh E, Propeck T, Jebson P, Jamadar D, Hayes C. Sonography of the scapholunate ligament in four cadaveric wrists: Correlation with MR arthrography and anatomy. 2002; AJR 179:523–527.
Metz VM, Wunderbaldinger P, Gilula LA. Update on imaging techniques of the wrist and hand. J Clin Plast Surg. 1996; 23:369–384.
Scheck R, Kubitzek C, Hierner R. The scapholunate interosseous ligament in MR arthrography of the wrist: correlation with nonenhanced MRI and wrist arthrography. Skeletal Radiol 1997; 26:263–271.
Chiou H, Chou YH, Chang CY. Ultrasonography of the wrist. Can Assoc Radiol J 2001; 52:302–311.
Zlatkin M, Chao P, Osterman A. Chronic wrist pain: evaluation with high resolution MR imaging. Radiology 1989; 173:723.
Golimbu C, Firoozina H, Melone C. Tears of the triangular fibrocartilage of the wrist: MR imaging. Radiology 1989; 173:731.
Schweitzer M, Brahme S, Holder J. Chronic wrist pain: spin echo and short tau inversion recovery MR imaging and conventional and MR arthrography. Radiolog. 1992; 182:205.
Acknowledgements
We wish to thank Bruce Weaver of the Department of Epidemiology at McMaster University. Patient data was collected from Guelph General Hospital, 115 Delhi St., Guelph, Ontario, Canada N1E 4J4 and Henderson General Hospital, 711 Concession St., Hamilton, Ontario, Canada L8 V 1C3
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Finlay, K., Lee, R. & Friedman, L. Ultrasound of intrinsic wrist ligament and triangular fibrocartilage injuries. Skeletal Radiol 33, 85–90 (2004). https://doi.org/10.1007/s00256-003-0698-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-003-0698-x