Three-compartment wrist arthrography: direct comparison of digital subtraction with nonsubtraction images.

PURPOSE

To determine the diagnostic value of digital subtraction and fluoroscopic spot images in wrist arthrography, alone and in combination.

MATERIALS AND METHODS

Randomized selective bilateral three-compartment wrist arthrography was performed in 64 patients. The fluoroscopic spot and digital subtraction images were read separately by two radiologists without knowledge of the clinical data.

RESULTS

One hundred twenty communicating defects were found in 69 wrists in 42 patients. Fluoroscopic spot radiographs alone depicted defects in all 69 wrists, but precise localization was not possible in 10 defects. Subtraction images alone demonstrated 59 defects. The defects not seen with digital subtraction imaging were identified after wrist motion. Digital subtraction images demonstrated defects earlier during the joint injection and demonstrated the exact site of the 10 defects not localized on the nonsubtracted images.

CONCLUSION

Digital subtraction and fluoroscopic spot images are complementary in wrist arthrography and, when used in combination, increase the ability to localize the sites of defects, although the value added by the subtraction technique is small.