TRIPLE-INJECTION WRIST ARTHROGRAPHY - UNIDIRECTIONAL COMMUNICATIONS ARE DUE TO TECHNICAL FACTORS

One justification for triple-injection wrist arthrography is detection of unidirectional interjoint communication that might escape notice i i only a single joint were injected. To determine whether the directio n of 1-way communications is related to the choice of the first joint injected, the authors prospectively randomized 100 wrists undergoing c onsecutive single-contrast, fluoroscopically controlled arthrograms in to 2 well-matched groups. One group received the initial injections in to the midcarpal and distal radioulnar joints and the other group rece ived the initial injection into the radiocarpal joint. Two unidirectio nal radial capsular communications with the radiocarpal joint were det ected on delayed midcarpal joint injection. No other unidirectional co mmunications were found. No statistically significant difference was f ound between the midcarpal and radiocarpal study groups. Thus, the fir st joint injected appears to be a major determinant in demonstrating u nidirectional communications between wrist compartments. Copyright (C) 1998 by the American Society for Surgery of the Hand.