Purpose
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.
Methods
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.
Results
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%).
Conclusions
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
Diagnostic III.
Key words
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Article info
Publication history
Accepted:
April 18,
2007
Received:
August 15,
2006
Footnotes
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.
Identification
Copyright
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
