WRIST ARTHROGRAPHY AFTER ACUTE TRAUMA TO THE DISTAL RADIUS - DIAGNOSTIC-ACCURACY, TECHNIQUE, AND SOURCES OF DIAGNOSTIC ERRORS

RATIONALE AND OBJECTIVES. The objective of this investigation was to d etermine the diagnostic accuracy of wrist arthrography in the detectio n of interosseous ligament disruptions and of triangular fibrocartilag e complex (TFCC) lesions in patients after acute wrist trauma and to d efine the sources of diagnostic error of wrist arthrography after rece nt trauma. METHODS. Twenty-two patients with radial fractures after ac ute wrist trauma underwent arthrography and arthroscopy of the wrist. Arthrography was performed in a standardized manner by two-or three-co mpartment injection technique. Subsequently wrist arthroscopy was perf ormed within the same session. Image analysis included the evaluation of interosseous carpal ligaments, the TFCC, and the osseous structures . RESULTS. In 22 patients, 11 injuries of the intrinsic ligaments and the TFCC were diagnosed by arthroscopy, of which 9 had been diagnosed correctly with arthrography before surgery. One scaphoid fracture prev iously missed on conventional radiographs also could be diagnosed by a rthrography. CONCLUSION. Arthrography of the posttraumatic wrist is a valuable tool in the diagnostic evaluation of interosseous carpal liga ments and the TFCC.