Fluoroscopic identification of torn intercarpal ligaments after injection of contrast material

La, Gilula; Hardy, DC; Totty, WG; Reinus, William R.

doi:10.2214/ajr.149.4.761

Cited by 24 publications

(8 citation statements)

References 7 publications

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“…With this technique, the injection process can be viewed dynamically, which can demonstrate communication between the adjacent compartments more precisely than conventional arthrography. 8,9 First, 0.4 mL of 0.5 mmol/mL gadolinium MR contrast agent can be diluted in 50 mL physiological saline solution and mixed with an equal amount of iodinated contrast agent. For the assessment of ligamentous lesions, a total of $1 to 2 mL of this solution can be administered with a 22-gauge needle injection into the distal radioulnar and the midcarpal compartment each, via a dorsal approach.…”

Section: Techniquementioning

confidence: 99%

Anatomy and Variants of the Triangular Fibrocartilage Complex and Its MR Appearance at 3 and 7T

Nöbauer-Huhmann

Pretterklieber

Erhart

et al. 2012

Semin Musculoskelet Radiol

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Due to the small size and complexity of its constituents, the triangular fibrocartilage complex (TFCC) has been a challenging structure for magnetic resonance (MR) imaging. Higher-field MR units, at 3T and 7T, with increased spatial resolution and the development of novel MR sequences, are promising tools for an improved visualization of the ulnocarpal complex. Anatomically, the TFCC consists of the TFC proper, the ulnomeniscal homolog, the ulnar collateral ligament, the ulnotriquetral and ulnolunate ligament, and radioulnar ligaments at the volar (palmar) and the dorsal side, as well as the sheath of the extensor carpi ulnaris tendon and the capsule of the distal radioulnar joint. This article describes the normal anatomy of the TFCC and its appearance on high-field MRI. Anatomical variants, such as the positive ulnar variance, and changes during pronation and supination are addressed.

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Section: Techniquementioning

confidence: 99%

Anatomy and Variants of the Triangular Fibrocartilage Complex and Its MR Appearance at 3 and 7T

Nöbauer-Huhmann

Pretterklieber

Erhart

et al. 2012

Semin Musculoskelet Radiol

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“…The existing imaging methods-bone scan, arthrogram, and even diagnostic arthroscopy-are all invasive and rather insensitive to diagnose grade I intrinsic ligament injury. 2,[47][48][49][50] Expensive but noninvasive MRI can be considered in this setting. However, the literature showing a significant variance in its sensitivity to grade I injury does not support the use of MRI in this setting.…”

Section: Ligament Injuriesmentioning

confidence: 99%

“…A three-phase arthrogram will likely have the sensitivity and specificity to accurately determine whether some portion of the ligament has a perforation, but this study does not permit staging of the presumed lesion. [48][49][50] Furthermore, the issue of distinguishing between an asymptomatic perforation or partial tear and one that is responsible for symptoms is a significant problem for arthrography in this setting. Many studies have shown that asymptomatic and mechanically insignificant degeneration and/or perforations of the intrinsic ligaments increase with age, particularly after the third decade of life.…”

Section: Ligament Injuriesmentioning

confidence: 99%

Information that Orthopedists Still Need to Know and What is Missing from the MR Images of the Wrist

Miller¹

2001

Semin Musculoskelet Radiol

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Magnetic resonance imaging (MRI) has a very established role in imaging many pathologic conditions in the wrist. MRI provides useful clinical information regarding neoplastic processes. It also provides valuable information in the evaluation of tendons and synovium in rheumatoid arthritis. However, it has been and is less useful when early ligamentous injuries, including grade I and grade II scapholunate and lunotriquetral ligament lesions, are suspected. Also, information regarding cartilage injuries and degeneration, especially in wrist instabilities, would be more than desirable for treating orthopedists and hand surgeons. However, at the current stage, this information is missing, and only the more advanced changes are seen in MRI. This article describes and explains clinical entities in which that information would help patient care and management.

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“…Eine arthroskopisch best ä tigte SL-Bandruptur wurde in der CT-Arthrografi e nicht erkannt. Bei der Beurteilung der CTArthrografi e ist zu ber ü cksichtigen, dass zwischen medio-und radiokarpalem Gelenkabschnitt vorbestehende, kommunizierende, degenerative Defekte oder Normvarianten des SL-Bandkomplexes wie der " pin-hole " -Defekt vorhanden sein k ö nnen [18,19] . Eine interkompartimentelle Kommunikation auf degenerativer Basis ist bereits ab dem 3.…”

Section: Introductionunclassified

Palmare Handgelenksarthroskopie zur Beurteilung karpaler Begleitläsionen bei der operativen Versorgung distaler intraartikulärer Radiusfrakturen

Hohendorff

Eck

Mühldorfer

et al. 2009

Handchir Mikrochir plast Chir

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Fractures of the distal radius, which currently are treated with palmar locking plates, are often accompanied by carpal lesions. Tears of the scapholunate interosseus ligament (SL) can affect the outcome. Between January 2007 and May 2008, 28 patients with distal intraarticular fractures of the radius were included in a prospective study. Preoperative CT-arthrography was performed. SL tears were found in 11 patients, with 10 partial and one complete rupture observed. A tear of the triangular fibrocartilage complex (TFCC) was detected in 16 patients. Every patient was operated with a palmar locking plate through a palmar approach between the flexor carpi radialis tendon and the radial artery. Then, a palmar wrist arthroscopy using a palmar portal was performed. Eleven SL tears with 9 partial and two total ruptures were diagnosed by arthroscopy. Ten lesions were associated with a C1-fracture with a fracture line projected onto the scapholunate interval. The TFCC was appraisable by palmar wrist arthroscopy only in 4 patients. Three of the SL tears detected by CT-arthrography could not be confirmed by palmar wrist arthroscopy. One complete rupture and one partial lesion confirmed by palmar wrist arthroscopy were found by CT-arthrography to be intact. Palmar wrist arthroscopy affords certainty when assessing the SL ligament. In this study, an assessment of ulnocarpal structures was not possible. For assessment of the ulnocarpal structures, CT-arthrography was superior to palmar wrist arthroscopy. However, the latter is an alternative during emergency treatment or when CT-arthrography is not available.

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Fluoroscopic identification of torn intercarpal ligaments after injection of contrast material

Cited by 24 publications

References 7 publications

Anatomy and Variants of the Triangular Fibrocartilage Complex and Its MR Appearance at 3 and 7T

Anatomy and Variants of the Triangular Fibrocartilage Complex and Its MR Appearance at 3 and 7T

Information that Orthopedists Still Need to Know and What is Missing from the MR Images of the Wrist

Palmare Handgelenksarthroskopie zur Beurteilung karpaler Begleitläsionen bei der operativen Versorgung distaler intraartikulärer Radiusfrakturen

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