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Related Experiment Videos

The triple-injection wrist arthrogram.

E M Zinberg1, A K Palmer, A B Coren

  • 1Department of Orthopedic Surgery, SUNY Health Science Center, Syracuse 13202.

The Journal of Hand Surgery
|November 1, 1988
PubMed
Summary
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Wrist arthrography using three injections (radiocarpal, distal radioulnar, and midcarpal joints) improves diagnostic accuracy. This comprehensive approach is essential for complete wrist evaluation, revealing abnormalities missed by standard methods.

Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Diagnostic Imaging

Background:

  • Wrist arthrography is a key diagnostic tool for wrist pain.
  • Standard arthrography often involves radiocarpal joint injection.
  • Limitations exist in detecting certain wrist pathologies with single-joint injections.

Purpose of the Study:

  • To evaluate the diagnostic yield of combined radiocarpal, distal radioulnar, and midcarpal joint injections.
  • To determine if multi-joint injections improve detection of wrist abnormalities compared to standard methods.
  • To assess the necessity of each injection for a complete wrist arthrographic evaluation.

Main Methods:

  • Retrospective review of 100 wrist arthrograms.
  • Inclusion of standard radiocarpal joint injection plus distal radioulnar and midcarpal joint injections.

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  • Analysis of arthrogram findings for each joint injection site.

    • Main Results:

    • 77% of patients showed abnormal arthrograms.
    • 29 cases had abnormalities detected only by distal radioulnar or midcarpal injections.
    • 38 cases had abnormalities detected by radiocarpal injection but not others.
    • 7 triangular fibrocartilage complex detachments were identified solely by distal radioulnar injection.
    • Midcarpal injection proved more valuable for radiocarpal-midcarpal communication evaluation.

    Conclusions:

    • Combined multi-joint wrist arthrography significantly enhances diagnostic accuracy.
    • Distal radioulnar and midcarpal joint injections are crucial for detecting specific pathologies.
    • All three injections are necessary for a comprehensive arthrographic assessment of the wrist.