Wrist ligament injuries: value of post-arthrography computed tomography

Objective: To evaluate the use of post-arthrography high-resolution compute d tomography in wrist ligament injuries. Design and patients: Thirty-six consecutive patients who had a history and clinical findings suggestive of ligamentous injuries of the wrist were pros pectively studied. The findings of three-compartment arthrography and post- arthrography computed tomography (arthro-CT) were compared with those of ar throscopy. The evaluation concentrates on the detection and precise localiz ation of ligament lesions in the triangular fibrocartilage (TFC), the scaph olunate ligament (SLL) and the lunotriquetral ligament (LTL). Results: For TFC, SLL and LTL lesions, standard arthrography responded with a sensitivity and specificity of 85% and 100%, 85% and 100%, 80% and 100% respectively, while arthro-CT showed a sensitivity and specificity of 85% a nd 100%, 100% and 100%, 80% and 100% respectively. The precise localization of the lesions was possible only with arthro-CT. Conclusion: The sensitivity and specificity of standard arthrography and ar thro-CT are similar, although the latter shows the site of tears or perfora tion with greater precision, while conventional arthrography demonstrates t hem indirectly. This precision is essential and may have clinical implicati ons for the success of treatment procedures.