The Journal of Bone and Joint Surgery, Vol 72, Issue 6 846-851, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
Digital subtraction arthrography of the wrist
RJ Belsole, SF Quinn, TL Greene, ME Beatty and JM Rayhack
Department of Orthopaedic Surgery, University of South Florida College of Medicine, Tampa.
Digital subtraction arthrography of the wrist was used to identify
abnormalities in eighty-six (60 per cent) of 139 patients during a
fifteen-month period. Multiple abnormalities were noted in thirty-four (25
per cent) of the wrists. The clinical signs and symptoms in the eighty-six
wrists did not always correlate with the defects that were seen on the
arthrograms. Three of five patients who had an isolated tear of the
scapholunate ligament, six of thirteen who had an isolated tear of the
lunotriquetral ligament, and seven of nineteen who had an isolated tear of
the triangular fibrocartilage complex also had signs and symptoms on the
opposite side of the wrist. Many of the lesions that were seen on
arthrography may have been serendipitous, degenerative, or unrelated to a
specific injury. There was a high prevalence of positive ulnar variance in
patients who had at least one ulnar abnormality. Capsular tears, most often
seen on the radiovolar aspect of the wrist, were best outlined by contrast
medium injected into the radiocarpal joint. The arthroscopic findings
differed from the arthrographic findings in five of the twenty patients in
whom both studies were done. The three-compartment technique of injection
is a valuable diagnostic tool. Injections of contrast medium into the
distal radio-ulnar joint outlined five of thirteen tears of the triangular
fibrocartilage complex that were not seen after injection into the
radiocarpal joint. Of the eleven tears that were seen after injection into
the radiocarpal joint, five were not seen when contrast medium was injected
into the distal radio-ulnar joint.
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