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Wrist arthrography: value of the three-compartment injection method.
E M Levinsohn1, I D Rosen, A K Palmer
1Department of Radiology, State University of New York, Syracuse 13210.
Radiology
|April 1, 1991
Summary
For complete wrist evaluation, injecting contrast material into the radiocarpal (RCJ), midcarpal (MCJ), and distal radioulnar (DRUJ) joints is essential. Separate injections significantly improve diagnostic yield for wrist abnormalities and triangular fibrocartilage complex tears.
Area of Science:
- Orthopedic Surgery
- Radiology
- Anatomy
Background:
- Wrist arthrography is a key diagnostic tool for evaluating wrist pain and injuries.
- Standard arthrography typically involves injection into the radiocarpal joint (RCJ).
- The triangular fibrocartilage complex (TFCC) and inter-joint communications are crucial for wrist function.
Purpose of the Study:
- To determine if adding midcarpal (MCJ) and distal radioulnar (DRUJ) joint injections to standard RCJ arthrography improves diagnostic yield.
- To assess the diagnostic contribution of individual joint injections in wrist arthrography.
Main Methods:
- Arthrography was performed on 300 consecutive patients.
- Contrast material was injected separately into the RCJ, MCJ, and DRUJ.
- Diagnostic findings from each injection site were recorded and analyzed.
Main Results:
- The addition of MCJ and DRUJ injections significantly increased the diagnostic yield compared to RCJ injection alone.
- Abnormalities were identified in 78 (26%) cases after MCJ or DRUJ injections alone.
- Twenty-seven percent of TFCC abnormalities and up to 29% of RCJ-MCJ communications were detected by isolated MCJ or DRUJ injections.
Conclusions:
- Separate injections into the RCJ, MCJ, and DRUJ are necessary for a comprehensive arthrographic evaluation of the wrist.
- A single-point injection may miss significant abnormalities, particularly involving the TFCC and inter-joint communications.