ARTHROGRAPHIC EVALUATION OF 1ST COMPARTMENT INJURY OF THE WRIST JOINT BY MULTIDETECTOR CT AND MRI

*Ezzat Alaa El Din Ali Abden Elsherif, Prof. Dr. Adel Mohamed Elwakeel, Dr. Mohamed Hafez Shaaban and Dr. Rehab Mohamed Habib 

ABSTRACT

Objectives: To assess role of CT arthrography and MR arthrography in detecting scapholunate ligament, lunotriquetral ligaments and triangular fibrocartilage complex injuries. Background: Wrist trauma is a common problem. Ligament injuries can lead to progressive instability with secondary deterioration of wrist joint. CT and MR arthrography are excellent techniques for determining the localization and extent of pathologic lesions of the triangular fibrocartilage complex and intrinsic carpal ligaments of the wrist. Patients and methods: The study included 30 patients with unilateral painful wrist to do CT and MR arthrography for wrist joint. A contrast mixture formed from MRI contrast agent, saline, iodinated contrast and local anesthesia prepared and injected intra-articular by CT guidance. Comparative CT and MR scanning done. Results of the analysis performed by two principal observers were compared. Concordant findings were accepted as the reference. Four cases with discordant or equivocal findings were reviewed by a third observer. Results: Sensitivities for CT arthrography for the 1st observer was 100% for SLL, LTL and TFCC injuries. For MRA was 100%, 75%, 85% & 100% for complete SLL tears, partial SLL tears of, partial LTL tears & TFCC tears respectively. Sensitivities for 2nd observer was 100% for all injuries by both CT arthrography and MR arthrography. Conclusion: Both CT and MR arthrography have high accuracy and reliable in diagnosis of intrinsic ligaments tears especially complete tears. However, CT arthrography is superior in the diagnosis of partial tears while MR arthrography is superior in diagnosis of early degenerative changes of triangular fibrocartilage.

Keywords: arthrography, magnetic resonance imaging, multidetector computed tomography, wrist joint, wrist Injuries.