Cheriex K C A L, Sulkers G S I, Terra M P, Schep N W L, van Aard B J P L, Strackee S D
Department of Plastic, Reconstructive and Hand Surgery, Onze Lieve Vrouw Gasthuis Oost, Oosterpark 9, 1091 AC, Amsterdam, The Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Eur J Radiol. 2017 Jul;92:45-50. doi: 10.1016/j.ejrad.2017.04.015. Epub 2017 Apr 25.
Scapholunate dissociation (SLD) is a form of carpal instability, caused by rupture of the scapholunate ligament (SLL) the secondary stabiliser of the scapholunate (SL) compartment. SLD can cause osteoarthritis of the wrist. Recently a study was published that shows cineradiography to be an excellent radiological imaging technique for diagnosing SLD at a tertiary centre for hand and wrist surgery [1]. As the quality of these results can be influenced by the expertise of the operator and observer of the cineradiographic studies, the aim of this study was to determine if these results were reproducible at a secondary centre for hand and wrist surgery with less expertise in wrist cineradiography. All cineradiographic studies carried out during a 10-year period were obtained. All patients who underwent the gold standard procedure (arthroscopy/arthrotomy) after cineradiography were included, a total of 50 patients. The diagnostic accuracy of detecting SLD by both cineradiography and conventional radiography was calculated. Cineradiography had a high diagnostic accuracy, while the accuracy for conventional radiography was average. When all wrists with an SL distance ≥3mm were excluded (static SLD), diagnostic accuracy for conventional radiography dropped even lower, while accuracy for cineradiography remained high. These results are comparable with published accuracy rates and show that cineradiography has a high diagnostic value for detecting SLD and do not seem to be influenced by the operator or observer of the cineradiographic studies.
舟月骨分离（SLD）是腕关节不稳定的一种形式，由舟月韧带（SLL）断裂引起，舟月韧带是舟月（SL）间隙的二级稳定结构。SLD可导致腕关节骨关节炎。最近发表的一项研究表明，在一家手和腕关节手术的三级中心，动态X线摄影是诊断SLD的一种优秀的放射成像技术[1]。由于这些结果的质量可能会受到动态X线摄影研究的操作者和观察者专业知识的影响，本研究的目的是确定在一家手和腕关节手术的二级中心，腕关节动态X线摄影专业知识较少的情况下，这些结果是否可重复。获取了10年期间进行的所有动态X线摄影研究。纳入了所有在动态X线摄影后接受金标准手术（关节镜检查/切开手术）的患者，共50例。计算了动态X线摄影和传统X线摄影检测SLD的诊断准确性。动态X线摄影具有较高的诊断准确性，而传统X线摄影的准确性一般。当排除所有SL间隙≥3mm的腕关节（静态SLD）时，传统X线摄影的诊断准确性甚至更低，而动态X线摄影的准确性仍然很高。这些结果与已发表的准确率相当，表明动态X线摄影在检测SLD方面具有较高的诊断价值，并且似乎不受动态X线摄影研究的操作者或观察者的影响。
