Ultrasound of intrinsic wrist ligament and triangular fibrocartilage injuries
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OBJECTIVE: The objective of this study was to evaluate ultrasound as a diagnostic tool for investigating scapholunate and lunatotriquetral ligamentous and triangular fibrocartilage (TFC) tears. Ultrasound findings were compared to conventional arthrogram findings, as the reference gold standard. DESIGN AND PATIENTS: In total 26 patients, 17 males and 9 females ranging in age from 17 to 35 (mean age, 34), were evaluated on referral for investigation of wrist pain. All patients were examined by high resolution ultrasound, using a 9-13 MHz transducer. All wrist ultrasound examinations were also compared to conventional tricompartmental arthrography, as the diagnostic gold standard reference. RESULTS: All ten scapholunate tears confirmed on arthrography were detected on ultrasound. Two of 8 lunatotriquetral and 7 of 11 TFC tears were correctly diagnosed on ultrasound. Sensitivity of ultrasound diagnosis ranged from 25% for lunatotriquetral tears to 100% for scapholunate tears. No false positive results were recorded for any of the three examined structures. CONCLUSION: The study results suggest that sonography is accurate for scapholunate tears, but is not accurate for evaluation of lunate-triquetral tears. It has intermediate accuracy for triangular fibrocartilage tears.
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