To determine the accuracy of computed tomography after wrist arthrogram (CT arthrogram) compared with findings during wrist arthroscopy as interpreted by a musculoskeletal radiologist and a board-certified hand surgeon.
Seventy-six consecutive patients who had a wrist CT arthrogram and subsequent wrist arthroscopy were identified in the arthroscopic database of four hand surgeons working at a single institution between 2001 and 2006. Operative findings were obtained from the medical record. A single, blinded, musculoskeletal fellowship-trained radiologist prospectively read all CT arthrograms focusing on the following areas: scapholunate interosseous ligament (SLIL), lunotriquetral interosseous ligament (LTIL), peripheral and central triangular fibrocartilage complex (TFCC), and chondral surfaces. Computed tomography arthrograms were also read in a blinded, prospective fashion by a single hand surgeon. The results of both readings were compared with the findings at the time of wrist arthroscopy.
Sixteen SLIL tears, 29 LTIL tears, 10 peripheral TFCC tears, and 33 central TFCC tears were identified at the time of wrist arthroscopy. Sensitivity and specificity of the CT arthrogram were calculated using arthroscopy findings as our reference standard. The radiologist’s readings (sensitivity, specificity) revealed the following: SLIL (94%, 86%), LTIL (85%, 79%), peripheral TFCC (30%, 94%), and central TFCC (88%, 95%). Results of CT arthrogram readings by the hand surgeon were SLIL (94%, 82%), LTIL (97%, 81%), peripheral TFCC (40%, 97%), and central TFCC (91%, 85%).
Computed tomography arthrogram of the wrist is highly accurate at detecting SLIL, LTIL, and central TFCC tears with high sensitivity and specificity. It is not as accurate at identifying peripheral tears.
Type of study/level of evidence
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Accepted: April 18, 2007
Received: August 15, 2006
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.