Reproducibility of X-rays and CT arthrography in SLAC, SNAC, SCAC wrists
R Belhaouane1, N Lebeau1, C Maes-Clavier1
1CHU d'Amiens, Orthopedic and Traumatologic Department, site sud, 80000 Amiens, France.
Hand Surgery & Rehabilitation
|November 29, 2016
Summary
CT arthrography and X-rays show variable reproducibility for diagnosing wrist collapse conditions like SLAC and SNAC. While CT arthrography is reliable, interpretation requires standardization for consistent clinical use.
Area of Science:
- Orthopedics
- Radiology
- Medical Imaging
Background:
- Scapholunate advanced collapse (SLAC), scaphoid non-union advanced collapse (SNAC), and scaphoid chondrocalcinosis advanced collapse (SCAC) are degenerative wrist conditions.
- Accurate diagnosis and assessment of these conditions are crucial for effective treatment planning.
Purpose of the Study:
- To evaluate the inter-observer and intra-observer reproducibility of CT arthrography and plain X-rays in diagnosing SLAC, SNAC, and SCAC wrist conditions.
- To assess the clinical relevance and diagnostic accuracy of these imaging modalities.
Main Methods:
- Radiological images (CT arthrography and plain X-rays) were reviewed twice by orthopedic surgeons and radiologists in a blinded, randomized manner.
- Reproducibility was analyzed using Cohen's kappa and Fleiss' kappa coefficients.
Main Results:
- Interpretation of CT arthrography showed inconsistent inter- and intra-observer reproducibility for overall diagnosis.
- Joint line assessment was reproducible within observers but not between different observers.
- Plain X-rays were insufficient for evaluating cartilage quality in degenerative wrist disease.
Conclusions:
- CT arthrography is a reliable imaging modality for wrist conditions, but its interpretation lacks standardization.
- Plain X-rays have limitations in assessing cartilage quality for degenerative wrist diseases.
- Diagnostic arthroscopy may be beneficial in cases with diagnostic uncertainty.
