Purpose
Although scapholunate interosseous ligament (SLIL) injury is often associated with
distal radius fracture, it is frequently missed in x-rays. The purpose of this study
was to develop a diagnostic classification based on ultrasonography for SLIL injury
and evaluate its diagnostic accuracy.
Methods
Patients who required surgery for distal radius fracture were included in this study.
Ultrasonography and arthroscopy were performed in all patients. The original ultrasonography-based
classification of the dorsal part of SLIL was developed as follows: for type A, the
SLIL surface was outlined clearly as a continuous flat line; for type B, the SLIL
surface was outlined clearly as a continuous bulged line; and for type C, the SLIL
surface was not continuous, smooth, or outlined clearly. Arthroscopy was performed
at the time of osteosynthesis. We classified its findings according to the arthroscopic
classification system of Geissler et al and evaluated interobserver and intraobserver
reliabilities for our classification on ultrasonography. We also studied the relationship
between the ultrasonographic and arthroscopic classifications.
Results
In total, 40 patients were included in this study. Weighted κ values for interobserver
and intraobserver reliabilities for our ultrasonographic classification were 0.83
(95% confidence interval, 0.70–0.96) and 0.88 (95% confidence interval, 0.77–0.99),
respectively. There were 17 patients with type A, 14 with type B, and 9 with type
C on ultrasonography. Ultrasonography had a sensitivity of 64% and specificity of
93% for the assumption that type C on ultrasonography corresponded to Geissler grades
3 and 4 on arthroscopy. No patient with type A on ultrasonography was classified as
Geissler grades 3 and 4 on arthroscopy.
Conclusions
We concluded that ultrasonography has a high specificity but low sensitivity for the
diagnosis of SLIL injury.
Type of study/level of evidence
Diagnostic Ⅱ.
Key words
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Article info
Publication history
Published online: July 17, 2020
Accepted:
May 27,
2020
Received:
July 27,
2019
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
