MRI of Normal Anatomy and Injuries of Extrinsic Ligaments

Shahabpour, Maryam; Ceuterick, P.; Allemon, B.; Pouliart, Nicole; Provyn, Steven; Maeseneer, Michel De

doi:10.1007/978-2-8178-0379-1_5

Cited by 3 publications

(10 citation statements)

References 26 publications

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“…The scapholunate ligament complex comprises not only the intrinsic SL ligament (with dorsal and palmar bands) but also the extrinsic palmar RC ligaments: radioscaphocapitate (RSC), long radiolunate (LRL), short radiolunate (SRL), and the intrinsic midcarpal scaphotrapeziotrapezoid (STT) ligament complex at the palmar side. It also includes the extrinsic dorsal radiocarpal (DRC) ligament, the DIC ligament, and the dorsal capsular scapholunate septum (DCSS) at the dorsal side [14][15][16][17] (►Table 1).…”

Section: Scapholunate Ligament Complexmentioning

confidence: 99%

“…Comparison with the normal contralateral side may help detect subtle changes in size, orientation, and signal intensity. 16,33,39 In a partial rupture, the RSC and/or LRL ligament can show an interruption of part of the fibers with irregular frayed outlines or a wavy appearance and an abnormal heterogeneous signal intensity; it can be loosened (►Fig. 5c).…”

Section: Scapholunate Ligament Complexmentioning

confidence: 99%

“…26,42 In our experience, chronic RC ligament lesions can be depicted on MRI, especially when using intravenous contrast injection. 15,16,39 The hyperemia of the surrounding synovium allows better visualization of the extrinsic ligaments than on MRI without contrast. 45 The extrinsic dorsal radiocarpal and midcarpal ligaments are located in the dorsal proximal RC and midcarpal planes described in arthroscopy.…”

Section: Scapholunate Ligament Complexmentioning

confidence: 99%

“…In the sagittal plane, the DCSS is obliquely oriented distally (upward) and dorsally. 15,16 Pathology: The DCSS is a pre-dynamic scapholunate joint stabilizer, and therefore tears of the DCSS could be a relevant factor in patients with scapholunate instability and may have therapeutic and prognostic implications. MRA (followed by CTA) can help diagnose DCSS tears according to the Van Overstraeten and Camus classification, although scientific evidence is not available.…”

Section: Scapholunate Ligament Complexmentioning

confidence: 99%

See 3 more Smart Citations

Extrinsic and Intrinsic Ligaments of the Wrist

Shahabpour

Abid

Overstraeten³

et al. 2021

Semin Musculoskelet Radiol

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Carpal stability depends on the integrity of both intra-articular and intracapsular carpal ligaments. In this review, the role of the radial-sided and ulnar-sided extrinsic and intrinsic ligaments is described, as well as their advanced imaging using magnetic resonance arthrography (MRA) and contrast-enhanced magnetic resonance imaging (MRI) with three-dimensional (3D) scapholunate complex sequences and thin slices. In the last decade, the new concept of a so-called “scapholunate complex” has emerged among hand surgeons, just as the triangular ligament became known as the triangular fibrocartilage complex (TFCC).The scapholunate ligament complex comprises the intrinsic scapholunate (SL), the extrinsic palmar radiocarpal: radioscaphocapitate (RSC), long radiolunate (LRL), short radiolunate (SRL) ligaments, the extrinsic dorsal radiocarpal (DRC) ligament, the dorsal intercarpal (DIC) ligament, as well as the dorsal capsular scapholunate septum (DCSS), a more recently described anatomical structure, and the intrinsic palmar midcarpal scaphotrapeziotrapezoid (STT) ligament complex. The scapholunate (SL) ligament complex is one of the most involved in wrist injuries. Its stability depends on primary (SL ligament) and secondary (RSC, DRC, DIC, STT ligaments) stabilizers.The gold standard for carpal ligament assessment is still diagnostic arthroscopy for many hand surgeons. To avoid surgery as a diagnostic procedure, advanced MRI is needed to detect associated lesions (sprains, midsubstance tears, avulsions and chronic fibrous infiltrations) of the extrinsic, midcarpal and intrinsic wrist ligaments, which are demonstrated in this article using 3D and two-dimensional sequences with thin slices (0.4 and 2 mm thick, respectively).

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Section: Scapholunate Ligament Complexmentioning

confidence: 99%

Section: Scapholunate Ligament Complexmentioning

confidence: 99%

Section: Scapholunate Ligament Complexmentioning

confidence: 99%

Section: Scapholunate Ligament Complexmentioning

confidence: 99%

See 2 more Smart Citations

Extrinsic and Intrinsic Ligaments of the Wrist

Shahabpour

Abid

Overstraeten³

et al. 2021

Semin Musculoskelet Radiol

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“…The MRI findings were correlated with clinical outcome or with arthroscopy (performed in 55 patients). 14,15 The patients were classified in three groups depending on the imaging technique: one group of 116 MRI using a 1.5T Symphony Vision (Siemens, Erlangen, Germany) with 2D PD and T2-weighted sequences performed in the three orthogonal planes with a slice thickness of 2 mm and a 3D DESS sequence obtained in the coronal plane; a second group of 78 contrast-enhanced MRI on a 3T Achieva (Philips, Best, The Netherlands) with intravenous contrast prior to the examination, using the same 2D sequences as well as a fat-saturated PD sequence in the coronal plane. The 3D sequences on 3T consisted of a 3D DESS and a fat-saturated 3D PD with a slice thickness of 0.5 mm in the coronal plane followed by orthogonal multiplanar reconstructions.…”

Section: Mr Imagingmentioning

confidence: 99%

Pathology of Extrinsic Ligaments: A Pictorial Essay

Shahabpour

Overstraeten

Ceuterick

et al. 2012

Semin Musculoskelet Radiol

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The role of the extrinsic ligaments, together with the intrinsic ligaments, appears to be much more important than previously thought in the setting of carpal stability. The anatomy and pathology of the extrinsic wrist ligaments is complex. Magnetic resonance imaging (MRI) with thin slices is essential for visualization. This article describes the pathological appearance of the extrinsic palmar and dorsal radiocarpal and ulnocarpal ligaments on MRI, correlated with arthroscopy (performed by two skilled hand surgeons), clinical findings, and follow-up. High-resolution MRI, especially using isotropic three-dimensional sequences with orthogonal multiplanar reconstructions on 3T MR systems, allows detailed depiction of many of the extrinsic ligaments affected in carpal injuries. Recognition of ligament abnormalities is improved by intra-articular or intravenous injection of contrast before the examination. Both techniques may help to determine the precise localization, size, and extent of dorsal and palmar radiocarpal and ulnocarpal ligament lesions. Further experience with these techniques is needed to define the place of MRI in the management of traumatic wrist injuries.

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Wrist Trauma: More Than Bones

Shahabpour¹,

Abid²,

Overstraeten³

et al. 2021

Journal of the Belgian Society of Radiology

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Acute and subacute wrist trauma predominantly consist of fractures of the distal radius in elderly patients and most frequently carpal fractures (scaphoid, followed by triquetrum and hamatum) and avulsion fractures of the ulnar styloid in younger patients, especially in sports-related injuries but also in work activities. The initial radiographs may miss the fractures and result when untreated in complications as nonunion, osteonecrosis, and degenerative osteoarthritis.Fractures of the distal radius and of the scaphoid may be associated with ligament injuries, most frequently the scapholunate complex, which are often overlooked at the emergency department. Patients without osseous injuries may present intrinsic and extrinsic ligament tears that may lead to carpal instability when they are clinically and/ or radiologically missed.Therefore, in acute and subacute setting, computed tomography may be helpful for the detection of subtle fractures, and magnetic resonance imaging, for the early diagnosis of occult fractures and ligament injuries.

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MRI of Normal Anatomy and Injuries of Extrinsic Ligaments

Cited by 3 publications

References 26 publications

Extrinsic and Intrinsic Ligaments of the Wrist

Extrinsic and Intrinsic Ligaments of the Wrist

Pathology of Extrinsic Ligaments: A Pictorial Essay

Wrist Trauma: More Than Bones

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