European Radiology

, Volume 27, Issue 12, pp 5344–5351 | Cite as

Quantitative analysis of scapholunate diastasis using stress speckle-tracking sonography: a proof-of-concept and feasibility study

  • Pedro Augusto Gondim Teixeira
  • Sammy Badr
  • Gabriela Hossu
  • Guillaume Lefebvre
  • Waled Abou Arab
  • Alain Blum
  • Anne Cotten



To evaluate the feasibility and potential clinical applicability of speckle-tracking sonography for the dynamic evaluation of the scapholunate diastasis during stress manoeuvres.

Material and methods

Two readers used speckle tracking sonography to evaluate scapholunate diastasis during a clenching fist manoeuver in 30 normal wrists. Scapholunate peak strain, mean scapholunate diastasis and the diastasis variation coefficient were analysed. IRB exemption was granted for this study. Conventional and stress wrist radiographs of 26 patients with and without a scapholunate ligament tear were retrospectively analysed to ascertain the range of variation in scapholunate diastasis.


Speckle-tracking parameters in normal wrists were similar between the two readers (p  > 0.2061). The maximal scapholunate peak strain during stress was relatively low (<0.34–0.47 mm). The normal radiographic diastasis amplitude was similar to maximal strain peak values in normal volunteers (0.49 ± 0.51 mm). The radiographic diastasis amplitude in cases of scapholunate ligament tears was 1.48 ± 0.78 mm, which was higher than the 95% confidence interval of the scapholunate gap peak strain.


Speckle-tracking sonography could represent an interesting alternative for stress evaluation of the scapholunate ligament in patients with scapholunate diastasis.

Key points

Speckle-tracking sonography can assess scapholunate diastasis under stress testing.

Scapholunate gap shows little variation under stress in healthy volunteers.

Scapholunate gap measurements are influenced by grip strength.

Sex and BMI have a significant influence on strain measurements.


Ultrasound Dynamic Quantitative Musculoskeletal Carpal instability 


Compliance with ethical standards


The scientific guarantor of this publication is Professor Anne Cotten.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.


This study has received funding by the Société française de radiologie (SFR) and the Collège des enseignants de Radiologie de France (CERF).

Statistics and biometry

One of the authors (Dr. Gabriela Hossu) has significant statistical expertise.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was obtained from all healthy volunteers in this study.

The images from the patients studied were retrospectively evaluated and written informed consent was not required.


• Volunteer study prospective, Patient study retrospective

• Observational

• Multicentre study

Supplementary material

330_2017_4915_MOESM1_ESM.mp4 (5.1 mb)
Electronic supplementary material 1 Video demonstrating the clenching fist manoeuvre and probe position during examination. (MP4 5258 kb)
330_2017_4915_MOESM2_ESM.mp4 (1.7 mb)
Electronic supplementary material 2 Video demonstrating the scapholunate gap strain in the right wrist of a 27 year-old female volunteer. (MP4 1732 kb)


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Pedro Augusto Gondim Teixeira
    • 1
    • 2
  • Sammy Badr
    • 3
  • Gabriela Hossu
    • 2
  • Guillaume Lefebvre
    • 3
  • Waled Abou Arab
    • 1
  • Alain Blum
    • 1
  • Anne Cotten
    • 3
  1. 1.Service D’imagerie GuillozHôpital CentralNancyFrance
  2. 2.Université de LorraineNancyFrance
  3. 3.Department of Radiology and Musculoskeletal ImagingCHRU Lille Centre de Consultations et d’Imagerie de l’Appareil LocomoteurLilleFrance

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