Hand Surgery > Diagnosis > Wrist Arthrographic Studies
Habib Olapade
UK pre law student; Falsely imprisoned in TX intending to move to CA, HI, or UK upon release.
A number of different studies may be helpful in establishing the proper diagnosis in a patient with hand or wrist pain. The choice of technique should be based on a careful history and physical exam. Arthrographic studies of the wrist facilitate evaluation of three different soft tissue stabilizing structures: the scapholunate ligament, lunotriquetral ligament, and triangular fibrocartilage complex. Here, a single radiocarpal injection tests the competence of each of the three structures to prevent dye from escaping the radiocarpal space. If dye is noted in the distal radioulnar joint, the triangular fibrocartilage complex is perforated. If dye is noted at the midcarpal level, the patient’s scapholunate or lunotriquetral ligament has been disrupted. Finally, because tears of the triangular fibrocartilage complex or ligaments may create a one-way valve phenomenon, separate midcarpal and distal radioulnar joint injections may reveal disruptions that are not apparent from the radiocarpal injection.