Quantitative analysis of scapholunate diastasis using stress speckle-tracking sonography: a proof-of-concept and feasibility study
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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.
• 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.
KeywordsUltrasound 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.
Institutional Review Board approval was obtained.
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
• Multicentre study
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