Borgese Marissa, Boutin Robert D, Bayne Christopher O, Szabo Robert M, Chaudhari Abhijit J
Department of Radiology, University of California - Davis, Sacramento, CA, 95817, USA.
Department of Orthopaedic Surgery, University of California - Davis, Sacramento, CA, 95817, USA.
Skeletal Radiol. 2017 Dec;46(12):1729-1737. doi: 10.1007/s00256-017-2747-x. Epub 2017 Aug 21.
Radiologic presentation of carpal instability at the radial side of the carpus, e.g. scapholunate diastasis following scapholunate interosseous ligament injury, has been studied extensively. By comparison, presentation at the ulnar-sided carpus has not. The purpose of this study was to assess the effects of lunate morphology, sex, and lunotriquetral interosseous ligament (LTIL) status on the radiologic measurement of the capitate-triquetrum joint (C-T distance). Further, we sought to evaluate the diagnostic accuracy of C-T distance for assessing LTIL injuries.
We retrospectively identified 223 wrists with wrist radiographs and MR arthrograms with contrast injection. Data collected included sex, lunate morphology and LTIL status from MR arthrography, and C-T distance from radiography. The effects of lunate morphology, sex, and LTIL injury status on C-T distance were evaluated using generalized linear models. Diagnostic performance of C-T distance was assessed by the area under receiver-operator characteristic curve (AUROC).
Lunate morphology, sex, and LTIL injury status all had significant effects on C-T distance; wrists with type II lunates, men, and wrists with LTIL injuries had greater C-T distances than wrists with type I lunates, women, and wrists without LTIL injuries, respectively (p < 0.01). The diagnostic value of the C-T distance for identifying patients with full-thickness LTIL tears was sufficient for women with type I (AUROC = 0.67) and type II lunates (0.60) and good for men with type I (0.72) and type II lunates (0.77). The demonstrated influence of LTIL status on C-T distance supports the use of C-T distance as a tool in assessing for full-thickness LTIL tears.
腕骨桡侧腕关节不稳定的影像学表现，如舟月骨间韧带损伤后的舟月骨分离，已得到广泛研究。相比之下，尺侧腕骨的表现尚未得到研究。本研究的目的是评估月骨形态、性别和月三角骨间韧带（LTIL）状态对头状骨 - 三角骨间关节（C - T距离）影像学测量的影响。此外，我们试图评估C - T距离对评估LTIL损伤的诊断准确性。
我们回顾性地确定了223例有腕部X线片和注射造影剂的磁共振关节造影的手腕。收集的数据包括性别、磁共振关节造影的月骨形态和LTIL状态，以及X线片的C - T距离。使用广义线性模型评估月骨形态、性别和LTIL损伤状态对C - T距离的影响。通过受试者工作特征曲线下面积（AUROC）评估C - T距离的诊断性能。
月骨形态、性别和LTIL损伤状态均对C - T距离有显著影响；II型月骨的手腕、男性以及LTIL损伤的手腕的C - T距离分别比I型月骨的手腕、女性以及无LTIL损伤的手腕更大（p < 0.01）。C - T距离对识别LTIL全层撕裂患者的诊断价值对于I型（AUROC = 0.67）和II型月骨的女性足够，对于I型（0.72）和II型月骨的男性良好（0.77）。LTIL状态对C - T距离的影响表明，C - T距离可作为评估LTIL全层撕裂的工具。
