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Digital subtraction arthrography of the wrist
R J Belsole1, S F Quinn, T L Greene
1Department of Orthopaedic Surgery, University of South Florida College of Medicine, Tampa.
Summary
Digital subtraction arthrography is a valuable wrist imaging tool, identifying abnormalities in 60% of patients. However, clinical correlation is not always present, and multiple injection sites improve diagnostic accuracy for wrist injuries.
Area of Science:
- Orthopedic Imaging
- Radiology
- Musculoskeletal System
Background:
- Wrist pain is common, with various potential causes.
- Accurate diagnosis of wrist ligament and cartilage injuries is crucial for effective treatment.
- Digital subtraction arthrography (DSA) is an imaging modality used to evaluate wrist abnormalities.
Purpose of the Study:
- To evaluate the diagnostic utility of digital subtraction arthrography (DSA) of the wrist.
- To assess the correlation between arthrographic findings and clinical symptoms.
- To determine the effectiveness of a three-compartment injection technique in DSA.
Main Methods:
- Digital subtraction arthrography (DSA) was performed on 139 patients over 15 months.
- Contrast medium was injected into the radiocarpal and distal radio-ulnar joints.
- Arthroscopic findings were compared to arthrographic findings in a subset of patients.
Main Results:
- Abnormalities were identified in 60% of wrists via DSA.
- Clinical signs and symptoms did not consistently correlate with arthrographic findings.
- The three-compartment injection technique improved the detection of triangular fibrocartilage complex tears.
Conclusions:
- DSA is a valuable diagnostic tool for wrist abnormalities.
- Correlation between clinical presentation and DSA findings can be variable.
- A multi-compartment injection approach enhances the sensitivity of DSA for specific wrist injuries.