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Bilateral arthrography of the wrist
T J Herbert1, R G Faithfull, D J McCann
1Sydney Hospital Hand Unit, Australia.
Journal of Hand Surgery (Edinburgh, Scotland)
|May 1, 1990
Summary
A unilateral wrist arthrogram has limited diagnostic value for wrist pain. Using the opposite asymptomatic wrist as a control is recommended for accurate arthrogram interpretation.
Area of Science:
- Orthopedics
- Radiology
- Diagnostic Imaging
Background:
- Wrist pain is a common complaint.
- Arthrograms are frequently used to investigate wrist pain.
- The diagnostic accuracy of unilateral wrist arthrograms is debated.
Purpose of the Study:
- To evaluate the diagnostic significance of a positive wrist arthrogram.
- To determine if a unilateral arthrogram provides reliable diagnostic information for wrist pain.
- To assess the utility of using the contralateral asymptomatic wrist as a control in arthrography.
Main Methods:
- A prospective trial involving 60 patients with wrist pain.
- Each patient underwent a wrist arthrogram.
- The opposite asymptomatic wrist served as a control in all cases.
Main Results:
- Of 46 patients with positive findings in the symptomatic wrist, 34 (74%) also had positive arthrograms in the asymptomatic contralateral wrist.
- This high rate of positive findings in asymptomatic wrists suggests a low specificity for unilateral arthrograms.
- The findings indicate significant overlap between symptomatic and asymptomatic wrist arthrogram results.
Conclusions:
- A unilateral wrist arthrogram has limited diagnostic value in investigating wrist pain.
- The contralateral asymptomatic wrist frequently shows positive findings, diminishing the reliability of unilateral results.
- Utilizing the opposite asymptomatic wrist as a control is crucial for accurate arthrogram interpretation in wrist pain assessment.