Radiocarpal Injuries: Cone Beam Computed Tomography Arthrography, Magnetic Resonance Arthrography, and Arthroscopic...

Area of Science:

• Orthopedic imaging
• Radiology
• Diagnostic imaging

Background:

• Wrist arthroscopy is used to evaluate chondral and ligamentous abnormalities in patients with wrist pain.
• Accurate diagnosis is crucial for effective treatment planning.

Purpose of the Study:

• To compare the diagnostic findings of wrist arthroscopy with cone beam computed tomography (CBCT) arthrography and magnetic resonance (MR) arthrography.
• To assess the sensitivity, specificity, and accuracy of CBCT arthrography versus MR arthrography in evaluating wrist structures.

Main Methods:

• 21 patients with wrist pain underwent CBCT arthrography, MR arthrography, and wrist arthroscopy.
• Evaluation focused on chondral surfaces (scaphoid, lunate, radius) and key ligaments (scapholunate, lunotriquetral, triangular fibrocartilage complex).
• Statistical analysis included sensitivity, specificity, predictive values, and accuracy with 95% confidence intervals.

Main Results:

• CBCT arthrography demonstrated slightly higher specificity and sensitivity for chondral lesions compared to MR arthrography, except for the lunate surface.
• For triangular fibrocartilage complex injuries, CBCT arthrography showed superior specificity and sensitivity.
• In ligamentous injuries, CBCT arthrography was more sensitive but less specific than MR arthrography, though confidence intervals overlapped due to small sample sizes.

Conclusions:

• CBCT arthrography is an emerging imaging modality with potential advantages over conventional CT and MRI.
• CBCT arthrography appears to be a valuable option for evaluating wrist pain, offering comparable diagnostic performance to MR arthrography.
• Further research with larger cohorts is recommended to explore its utility, especially for ligamentous injuries.