Evaluation of chronic wrist pain by arthrography, arthroscopy, and arthrotomy

Arthrography and arthroscopy of the wrist were compared as diagnostic tools in the evaluation of chronic wrist pain. Arthroscopy proved to be a more sensitive procedure than arthrography in 20 consecutive patients with confirmed wrist injuries. There was 86% correlation (the exception--one false negative arthroscopic procedure) between arthroscopy and arthrography in eight patients with triangular fibrocartilage tears. Compared with arthroscopy, there were five false negative and five false positive arthrograms when evaluating interosseous scapholunate and lunotriquetral ligament tears. Arthroscopy more readily identified the location and extent of triangular fibrocartilage and the significance of interosseous ligament tears. Wrist arthrotomy confirmed the findings of wrist arthrography and arthroscopy and demonstrated that arthrography is not as accurate in localizing specific wrist injuries. Furthermore, wrist arthroscopy is a more valuable technique in determining the location, size, and extent of ligament injuries within the wrist.