Evaluating Accuracy of Plain Magnetic Resonance Imaging or Arthrogram versus Wrist Arthroscopy in the Diagnosis of Scapholunate Interosseous Ligament Injury

Nardeen Kader; Mohammed Shoaib Arshad; Pawan K. Chajed; Daoud Makki; Kiran Naikoti; David Temperley; S. Raj Murali

doi:10.1055/s-0040-1719231

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2022; 14(04): 298-303
DOI: 10.1055/s-0040-1719231

Original Article

Evaluating Accuracy of Plain Magnetic Resonance Imaging or Arthrogram versus Wrist Arthroscopy in the Diagnosis of Scapholunate Interosseous Ligament Injury

Nardeen Kader

¹Upper Limb Unit, Trauma and Orthopaedics, Wrightington Hospital, Wigan, United Kingdom

,

Mohammed Shoaib Arshad

¹Upper Limb Unit, Trauma and Orthopaedics, Wrightington Hospital, Wigan, United Kingdom

,

Pawan K. Chajed

¹Upper Limb Unit, Trauma and Orthopaedics, Wrightington Hospital, Wigan, United Kingdom

,

Daoud Makki

¹Upper Limb Unit, Trauma and Orthopaedics, Wrightington Hospital, Wigan, United Kingdom

,

Kiran Naikoti

¹Upper Limb Unit, Trauma and Orthopaedics, Wrightington Hospital, Wigan, United Kingdom

,

David Temperley

¹Upper Limb Unit, Trauma and Orthopaedics, Wrightington Hospital, Wigan, United Kingdom

,

S. Raj Murali

¹Upper Limb Unit, Trauma and Orthopaedics, Wrightington Hospital, Wigan, United Kingdom

› Author Affiliations

Abstract

Introduction Scapholunate interosseous ligament injury (SLIL) is the most common cause of wrist instability and a cause of morbidity in a proportion of patients with wrist injuries.

Aim To evaluate the accuracy of plain magnetic resonance imaging (MRI) and MR arthrogram (MRA) in the diagnosis of SLIL injury against the existing gold standard-wrist arthroscopy.

Materials and Methods We retrospectively reviewed 108 cases by comparing MRI/MRA reports and their wrist arthroscopy operation notes.

Results Overall MRI sensitivity to SLIL injuries was 38.5% (91.0% specificity). When broken down into plain MRI and MRA the results were: plain MRI sensitivity = 19.2% (91.4% specificity) and MRA sensitivity = 57.7% (90.5% specificity).

Conclusion Neither MRI nor MRA scanning is sensitive enough compared with the gold standard. Positive predictive value remains too low (62.5 and 88.2%, respectively) to consider bypassing diagnostic arthroscopy and treating surgically. The negative predictive value (60.4 and 63.6%, respectively) is inadequate to confirm exclusion of injury from MRI results alone.

Keywords

scapholunate ligament injury - diagnosis - evaluation - magnetic resonance imaging - arthroscopy

Full Text

References

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