The Journal of Bone and Joint Surgery, Vol 77, Issue 8 1207-1209, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Arthrography of the wrist. Assessment of the integrity of the ligaments in young asymptomatic adults
D Kirschenbaum, S Sieler, D Solonick, DM Loeb and RP Cody
Robert Wood Johnson University Hospital, New Brunswick, New Jersey, USA.
Fifty-two asymptomatic adults who were between twenty and thirty-five years
old had arthrography of the wrist with use of a single injection into the
radiocarpal joint. The purpose of the study was to evaluate the integrity
of the triangular fibrocartilage, the scapholunate ligament, and the
lunotriquetral ligament. Contrast medium was injected under fluoroscopic
guidance, and posteroanterior and lateral radiographs of the wrist were
made after the subjects had performed exercises of the wrist. No patient
who had a history of trauma to the wrist, pain in the wrist, or
inflammatory arthritis was included in the study. All of the subjects had
an examination of both upper extremities that included measurement of the
active motion of the wrist with a goniometer, strength-testing with a Jamar
dynamometer, ballottement and testing for impingement, and palpation for
tenderness. Plain radiographs were evaluated, and the ulnar variance was
recorded. The arthrograms revealed an abnormal communication of the
contrast medium in fourteen wrists (27 per cent), and four of the fourteen
had multiple areas of communication. The abnormal communication was through
the triangular fibrocartilage alone in six wrists, the scapholunate
ligament alone in two wrists, the lunotriquetral ligament alone in two
wrists, and in more than one of these areas in four wrists. A positive
arthrogram was associated with a greater positive ulnar variance. All of
the subjects had symmetrical motion of the wrists and grip strength, and
none of them had tenderness in the wrist. There were no complications
related to the arthrography. Perforation of a ligament in the wrist is
common in young asymptomatic adults.(ABSTRACT TRUNCATED AT 250 WORDS)
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