Fluoroscopic and arthrographic evaluation of carpal instability

Area of Science:

• Orthopedics
• Radiology
• Sports Medicine

Background:

• Wrist pain often presents diagnostic challenges.
• Conventional methods may not identify all causes of wrist pain.

Purpose of the Study:

• To evaluate a diagnostic protocol for unexplained wrist pain.
• To assess the combined efficacy of videotape fluoroscopy and radiocarpal arthrography.

Main Methods:

• Videotape fluoroscopy of carpal motion was the initial study.
• Radiocarpal arthrography was performed selectively after fluoroscopy.
• Surgical correlation was used to confirm diagnoses.

Main Results:

• The combined protocol yielded a diagnosis in 76% of cases.
• Videotape fluoroscopy alone was positive in 66% of patients.
• Arthrography increased the diagnostic yield when fluoroscopy was normal or inconclusive.

Conclusions:

• The diagnostic protocol is effective for ligament tears and instability.
• Videotape fluoroscopy should be the primary imaging modality.
• Radiocarpal arthrography is valuable for refining diagnoses.