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Comparison of Radiographic Stress Views in Detecting Scapholunate Ligament Injuries: A Cadaveric Model Study.

Usama Farghaly Omar1, Jingwen Ng2, Wei Ping Sim1

  • 1Hand and Reconstructive Microsurgery Service, Orthopaedic Surgery Department, Khoo Teck Puat Hospital, Singapore 768828, Singapore.

Journal of Clinical Medicine
|October 16, 2025
PubMed
Summary

Posteroanterior (PA) wrist extension and anteroposterior (AP) clenched fist views are most effective for diagnosing scapholunate ligament injuries. These stress radiography techniques offer accessible, cost-effective early detection of wrist ligament pathology.

Keywords:
cadaveric studydiagnostic imagingscapholunate ligamentstress radiographswrist instability

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Area of Science:

  • Orthopedic Surgery
  • Radiology
  • Musculoskeletal Imaging

Background:

  • Scapholunate ligament injuries are difficult to diagnose with standard radiographs.
  • Optimal stress radiographic views for these injuries are not well-defined.

Purpose of the Study:

  • To compare the diagnostic utility of eight stress radiographic views for scapholunate ligament disruption.
  • Utilize a cadaveric model to evaluate radiographic techniques.

Main Methods:

  • Nine cadaveric wrists underwent scapholunate ligament transection.
  • Eight radiographic views were assessed, including PA and AP positions with various wrist movements.
  • Scapholunate gap measurements were analyzed using digital software.

Main Results:

  • PA wrist extension and AP clenched fist views showed significant scapholunate gap widening.
  • PA wrist flexion resulted in gap reduction.
  • Variability in gap measurements was observed across different views and specimens.

Conclusions:

  • PA wrist extension and AP clenched fist views are superior for detecting scapholunate ligament injuries.
  • These stress radiography methods provide accessible, cost-effective early detection.
  • These techniques can aid in clinical diagnosis of scapholunate ligament pathology.