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Sonography and Sonoarthrography of the Scapholunate and Lunotriquetral Ligaments and Triangular Fibrocartilage Disk

Initial Experience and Correlation With Arthrography and Magnetic Resonance Arthrography

Department of Radiology, University of Arizona Health Sciences Center, Tucson, Arizona USA (M.S.T., T.B.H., L.F.R.); Department of Orthopedic Surgery, University of Arizona College of Medicine, Tucson, Arizona USA (J.E.S.); Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts USA (M.D.J.); and Department of Orthopedic Surgery, Mercy San Juan Medical Center, Carmichael, California USA (D.N.S.).

Address correspondence to Mihra S. Taljanovic, MD, MA, Department of Radiology, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724 USA. E-mail: mihrat{at}radiology.arizona.edu

Objective. The purpose of this study was to determine the utility of sonography and sonoarthrography in evaluation of dorsal bands of the scapholunate ligament (SLL), lunotriquetral ligament (LTL), and triangular fibrocartilage (TFC) disk in correlation with arthrography and magnetic resonance arthrography (MRA). Methods. High-resolution sonography of the SLL, LTL, and TFC disk was performed on symptomatic wrists in 16 patients referred by a hand surgeon for MRA of the symptomatic wrists. All patients then underwent arthrography and an MRA study of the same wrist. After MRA, sonography was repeated. The imaging findings of these different techniques were then compared. Four patients (25%) underwent surgery of their wrists. In these 4 patients, the surgical and imaging findings were correlated. Results. For the SLL, the results were concordant for all imaging modalities in 15 patients (93.75%) and partially concordant in 1 (6.25%). For the LTL, the results were concordant for all imaging modalities in 12 patients (75%), partially concordant in 3 (18.75%), and discordant in 1 (6.25%). For the TFC disk, the results were concordant for all imaging modalities in 13 patients (81.25%), partially concordant in 2 (12.5%), and discordant in 1 (6.25%). The arthroscopic and imaging findings were concordant for 3 SLLs, 3 LTLs, and 3 TFC disks. Conclusions. Our preliminary results are encouraging. Sonography may be used at least as a screening imaging modality in evaluation of the SLL and TFC disk. Sonoarthrography improves evaluation of the LTL.

Key Words: lunotriquetral ligament • schapholunate ligament • sonoarthrography • sonography • triangular fibrocartilage

Abbreviations: CTA, computed tomographic arthrography • ECU, extensor carpi ulnaris • LTL, lunotriquetral ligament • MRA, magnetic resonance arthrography • MRI, magnetic resonance imaging • NPV, negative predictive value • PPV, positive predictive value • SLL, scapholunate ligament • TE, echo time • TFC, triangular fibrocartilage • T1W, T1-weighted • TR, repetition time