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30.04.2018 | Computed Tomography

Scapholunate instability: improved detection with semi-automated kinematic CT analysis during stress maneuvers

verfasst von: Waled Abou Arab, Aymeric Rauch, Mohammad B. Chawki, Francois Dap, Gilles Dautel, Alain Blum, Pedro Augusto Gondim Teixeira

Erschienen in: European Radiology | Ausgabe 10/2018

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Abstract

Objectives

To evaluate the diagnostic performance of radioulnar deviation (RUD) and clenching fist (CF) maneuvers for the evaluation of scapholunate dissociation (SLD) using quantitative kinematic CT.

Methods

Thirty-seven patients with suspected scapholunate instability were prospectively evaluated with kinematic CT. Two radiologists independently evaluated the SLD during RUD and CF maneuvers. Various dynamic parameters describing SLD were compared (maximal value, variation coefficient and range) in patients with and without scapholunate ligament ruptures confirmed by CT arthrography.

Results

SLD in CF varied from 3.17 ± 0.38 to 3.24 ± 0.80 mm in controls and from 4.11 ± 0.77 and 4.01 ± 0.85 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p < 0.009). SLD in RUD varied from 3.35 ± 0.51 and 3.01 ± 0.78 mm in controls and from 4.51 ± 1.26 to 4.42 ± 1.75 mm in patients with scapholunate ligament ruptures for reader 1 and 2 (p varied from 0.001 to 0.002). The inter-observer variability was better for RUD (ICC = 0.85 versus 0.6 for RUD and CF respectively).

Conclusion

Analysis of SLD using kinematic CT has shown significant measurement differences between the groups with or without scapholunate instability with good diagnostic performance.

Key Points

• Kinematic CT can quantitatively assess scapholunate dissociation.
• SLD analysis on kinematic CT has excellent reproducibility with radioulnar deviation maneuver.
• Scapholunate dissociation was significantly different in patients with and without instability.
• Diagnostic performance for scapholunate instability identification was better with radioulnar deviation.
Literatur
1.
Zurück zum Zitat Kitay A, Wolfe SW (2012) Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am 37:2175–2196CrossRef Kitay A, Wolfe SW (2012) Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am 37:2175–2196CrossRef
2.
Zurück zum Zitat Lee DH, Dickson KF, Bradley EL (2004) The incidence of wrist interosseous ligament and triangular fibrocartilage articular disc disruptions: a cadaveric study. J Hand Surg Am 29:676–684CrossRef Lee DH, Dickson KF, Bradley EL (2004) The incidence of wrist interosseous ligament and triangular fibrocartilage articular disc disruptions: a cadaveric study. J Hand Surg Am 29:676–684CrossRef
3.
Zurück zum Zitat Kuo CE, Wolfe SW (2008) Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am 33:998–1013CrossRef Kuo CE, Wolfe SW (2008) Scapholunate instability: current concepts in diagnosis and management. J Hand Surg Am 33:998–1013CrossRef
4.
Zurück zum Zitat Schimmerl-Metz SM, Metz VM, Totterman SM et al (1999) Radiologic measurement of the scapholunate joint: implications of biologic variation in scapholunate joint morphology. J Hand Surg Am 24:1237–1244CrossRef Schimmerl-Metz SM, Metz VM, Totterman SM et al (1999) Radiologic measurement of the scapholunate joint: implications of biologic variation in scapholunate joint morphology. J Hand Surg Am 24:1237–1244CrossRef
5.
Zurück zum Zitat Cautilli GP, Wehbé MA (1991) Scapho-lunate distance and cortical ring sign. J Hand Surg Am 16:501–503CrossRef Cautilli GP, Wehbé MA (1991) Scapho-lunate distance and cortical ring sign. J Hand Surg Am 16:501–503CrossRef
6.
Zurück zum Zitat Pliefke J, Stengel D, Rademacher G et al (2008) Diagnostic accuracy of plain radiographs and cineradiography in diagnosing traumatic scapholunate dissociation. Skeletal Radiol 37:139–145CrossRef Pliefke J, Stengel D, Rademacher G et al (2008) Diagnostic accuracy of plain radiographs and cineradiography in diagnosing traumatic scapholunate dissociation. Skeletal Radiol 37:139–145CrossRef
7.
Zurück zum Zitat Kwon BC, Baek GH (2008) Fluoroscopic diagnosis of scapholunate interosseous ligament injuries in distal radius fractures. Clin Orthop Relat Res 466:969–976CrossRef Kwon BC, Baek GH (2008) Fluoroscopic diagnosis of scapholunate interosseous ligament injuries in distal radius fractures. Clin Orthop Relat Res 466:969–976CrossRef
8.
Zurück zum Zitat Lee YH, Choi YR, Kim S et al (2013) Intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist: comparison of isovolumetric 3D-THRIVE sequence MR arthrography and conventional MR image at 3 T. Magn Reson Imaging 31:221–226CrossRef Lee YH, Choi YR, Kim S et al (2013) Intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist: comparison of isovolumetric 3D-THRIVE sequence MR arthrography and conventional MR image at 3 T. Magn Reson Imaging 31:221–226CrossRef
9.
Zurück zum Zitat Gondim Teixeira PA, Formery A-S, Jacquot A et al (2017) Quantitative analysis of subtalar joint motion with 4D CT: proof of concept with cadaveric and healthy subject evaluation. AJR Am J Roentgenol 208:150–158CrossRef Gondim Teixeira PA, Formery A-S, Jacquot A et al (2017) Quantitative analysis of subtalar joint motion with 4D CT: proof of concept with cadaveric and healthy subject evaluation. AJR Am J Roentgenol 208:150–158CrossRef
10.
Zurück zum Zitat Demehri S, Hafezi-Nejad N, Morelli JN et al (2016) Scapholunate kinematics of asymptomatic wrists in comparison with symptomatic contralateral wrists using four-dimensional CT examinations: initial clinical experience. Skeletal Radiol 45:437–446CrossRef Demehri S, Hafezi-Nejad N, Morelli JN et al (2016) Scapholunate kinematics of asymptomatic wrists in comparison with symptomatic contralateral wrists using four-dimensional CT examinations: initial clinical experience. Skeletal Radiol 45:437–446CrossRef
11.
Zurück zum Zitat Mat Jais IS, Tay SC (2017) Kinematic analysis of the scaphoid using gated four-dimensional CT. Clin Radiol 72:794.e1–794.e9CrossRef Mat Jais IS, Tay SC (2017) Kinematic analysis of the scaphoid using gated four-dimensional CT. Clin Radiol 72:794.e1–794.e9CrossRef
12.
Zurück zum Zitat Shores JT, Demehri S, Chhabra A (2013) Kinematic “4 dimensional” CT imaging in the assessment of wrist biomechanics before and after surgical repair. Eplasty 13:e9PubMedPubMedCentral Shores JT, Demehri S, Chhabra A (2013) Kinematic “4 dimensional” CT imaging in the assessment of wrist biomechanics before and after surgical repair. Eplasty 13:e9PubMedPubMedCentral
13.
Zurück zum Zitat Leng S, Zhao K, Qu M et al (2011) Dynamic CT technique for assessment of wrist joint instabilities. Med Phys 38:S50CrossRef Leng S, Zhao K, Qu M et al (2011) Dynamic CT technique for assessment of wrist joint instabilities. Med Phys 38:S50CrossRef
14.
Zurück zum Zitat Kakar S, Breighner RE, Leng S et al (2016) The role of dynamic (4D) CT in the detection of scapholunate ligament injury. J Wrist Surg 5:306–310CrossRef Kakar S, Breighner RE, Leng S et al (2016) The role of dynamic (4D) CT in the detection of scapholunate ligament injury. J Wrist Surg 5:306–310CrossRef
15.
Zurück zum Zitat Gervaise A, Osemont B, Lecocq S et al (2012) CT image quality improvement using Adaptive Iterative Dose Reduction with wide-volume acquisition on 320-detector CT. Eur Radiol 22:295–301CrossRef Gervaise A, Osemont B, Lecocq S et al (2012) CT image quality improvement using Adaptive Iterative Dose Reduction with wide-volume acquisition on 320-detector CT. Eur Radiol 22:295–301CrossRef
16.
Zurück zum Zitat Garcia-Elias M, Alomar Serrallach X, Monill Serra J (2014) Dart-throwing motion in patients with scapholunate instability: a dynamic four-dimensional computed tomography study. J Hand Surg Am Eur Vol 39:346–352CrossRef Garcia-Elias M, Alomar Serrallach X, Monill Serra J (2014) Dart-throwing motion in patients with scapholunate instability: a dynamic four-dimensional computed tomography study. J Hand Surg Am Eur Vol 39:346–352CrossRef
17.
Zurück zum Zitat Gondim Teixeira PA, Formery A-S, Hossu G et al (2017) Evidence-based recommendations for musculoskeletal kinematic 4D-CT studies using wide area-detector scanners: a phantom study with cadaveric correlation. Eur Radiol 27:437–446CrossRef Gondim Teixeira PA, Formery A-S, Hossu G et al (2017) Evidence-based recommendations for musculoskeletal kinematic 4D-CT studies using wide area-detector scanners: a phantom study with cadaveric correlation. Eur Radiol 27:437–446CrossRef
18.
Zurück zum Zitat Peymani A, Foumani M, Dobbe JGG et al (2017) Four-dimensional rotational radiographic scanning of the wrist in patients after proximal row carpectomy. J Hand Surg Am Eur 42:846–851CrossRef Peymani A, Foumani M, Dobbe JGG et al (2017) Four-dimensional rotational radiographic scanning of the wrist in patients after proximal row carpectomy. J Hand Surg Am Eur 42:846–851CrossRef
19.
Zurück zum Zitat Foumani M, Strackee SD, Stekelenburg CM et al (2015) Dynamic in vivo evaluation of radiocarpal contact after a 4-corner arthrodesis. J Hand Surg Am 40:759–766CrossRef Foumani M, Strackee SD, Stekelenburg CM et al (2015) Dynamic in vivo evaluation of radiocarpal contact after a 4-corner arthrodesis. J Hand Surg Am 40:759–766CrossRef
20.
Zurück zum Zitat Foumani M, Strackee SD, van de Giessen M et al (2013) In-vivo dynamic and static three-dimensional joint space distance maps for assessment of cartilage thickness in the radiocarpal joint. Clin Biomech (Bristol, Avon) 28:151–156CrossRef Foumani M, Strackee SD, van de Giessen M et al (2013) In-vivo dynamic and static three-dimensional joint space distance maps for assessment of cartilage thickness in the radiocarpal joint. Clin Biomech (Bristol, Avon) 28:151–156CrossRef
21.
Zurück zum Zitat Halpenny D, Courtney K, Torreggiani WC (2012) Dynamic four-dimensional 320 section CT and carpal bone injury—a description of a novel technique to diagnose scapholunate instability. Clin Radiol 67:185–187CrossRef Halpenny D, Courtney K, Torreggiani WC (2012) Dynamic four-dimensional 320 section CT and carpal bone injury—a description of a novel technique to diagnose scapholunate instability. Clin Radiol 67:185–187CrossRef
22.
Zurück zum Zitat Lombard C, Gervaise A, Villani N et al (2018) The impact of dose reduction in quantitative kinematic CT of ankle joints using a full model based iterative reconstruction algorithm: a cadaveric study. AJR Am J Roentgenol 210:396–403CrossRef Lombard C, Gervaise A, Villani N et al (2018) The impact of dose reduction in quantitative kinematic CT of ankle joints using a full model based iterative reconstruction algorithm: a cadaveric study. AJR Am J Roentgenol 210:396–403CrossRef
23.
Zurück zum Zitat Bille B, Harley B, Cohen H (2007) A comparison of CT arthrography of the wrist to findings during wrist arthroscopy. J Hand Surg Am 32:834–841CrossRef Bille B, Harley B, Cohen H (2007) A comparison of CT arthrography of the wrist to findings during wrist arthroscopy. J Hand Surg Am 32:834–841CrossRef
24.
Zurück zum Zitat Forsberg D, Lindblom M, Quick P, Gauffin H (2016) Quantitative analysis of the patellofemoral motion pattern using semi-automatic processing of 4D CT data. Int J Comput Assist Radiol Surg 11:1731–1741CrossRef Forsberg D, Lindblom M, Quick P, Gauffin H (2016) Quantitative analysis of the patellofemoral motion pattern using semi-automatic processing of 4D CT data. Int J Comput Assist Radiol Surg 11:1731–1741CrossRef
25.
Zurück zum Zitat Gondim Teixeira PA, Badr S, Hossu G et al (2017) Quantitative analysis of scapholunate diastasis using stress speckle-tracking sonography: a proof-of-concept and feasibility study. Eur Radiol 27:5344–5351CrossRef Gondim Teixeira PA, Badr S, Hossu G et al (2017) Quantitative analysis of scapholunate diastasis using stress speckle-tracking sonography: a proof-of-concept and feasibility study. Eur Radiol 27:5344–5351CrossRef
Metadaten
Titel
Scapholunate instability: improved detection with semi-automated kinematic CT analysis during stress maneuvers
verfasst von
Waled Abou Arab
Aymeric Rauch
Mohammad B. Chawki
Francois Dap
Gilles Dautel
Alain Blum
Pedro Augusto Gondim Teixeira
Publikationsdatum
30.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5430-2

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