EVALUATION OF CHRONIC WRIST PAIN BY ARTHROGRAPHY, ARTHROSCOPY, AND ARTHROTOMY

Arthrography and arthroscopy of the wrist were compared as diagnostic tools in the evaluation of chronic wrist pain. Arthroscopy proved to b e a more sensitive procedure than arthrography in 20 consecutive patie nts with confirmed wrist injuries. There was 86% correlation (the exce ption-one false negative arthroscopic procedure) between arthroscopy a nd arthrography in eight patients with triangular fibrocartilage tears . Compared with arthroscopy, there were five false negative and five f alse positive arthrograms when evaluating interosseous scapholunate an d lunotriquetral ligament tears. Arthroscopy more readily identified t he location and extent of triangular fibrocartilage and the significan ce of interosseous ligament tears. Wrist arthrotomy confirmed the find ings of wrist arthrography and arthroscopy and demonstrated that arthr ography is not as accurate in localizing specific wrist injuries. Furt hermore, wrist arthroscopy is a more valuable technique in determining the location, size, and extent of ligament injuries within the wrist.