Evaluation of dorsal subluxation of the scaphoid in patients with scapholunate ligament tears: a four-dimensional CT study.
Fiche publication
Date publication
juillet 2020
Journal
AJR. American journal of roentgenology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr TEIXEIRA GONDIM Pedro
Tous les auteurs :
Gondim Teixeira PA, Blanc JB, Rauch A, Abou Arab W, Hossu G, Athlani L, Blum A
Lien Pubmed
Résumé
Please see the Author Video associated with this article. To evaluate the variation of the posterior radioscaphoid angle (PRSA) in patients with and without scapholunate ligament (SLL) tears during wrist radio-ulnar deviation. Seventy-three patients with clinically suspected scapholunate instability were prospectively evaluated with 4DCT and CT arthrography from February 2015 to April 2018. The PRSA is the angle formed between the articular surface of the scaphoid fossa of the radius and the most posterior point of the scaphoid in the sagittal plane. This angle was calculated by two independent radiologists during radioulnar deviation. PRSA values were correlated to the SLL status and the presence of a scapholunate diastasis on conventional radiographs with a clenched fist. Mean PRSA values in patients without and with a scapholunate diastasis were 98-99° and 107-111°, respectively. The PRSA variation amplitude was 7.6-9.3° in the subgroups studied. The reproducibility of PRSA measurement was considered good (ICC = 0.73). PRSA mean values increased 6-10% and 12-14% when patients with intact SLL were compared to those with partial tears and full tears, respectively ( < 0.001). These values also increased in patients with diastasis compared with patients without diastasis (8-13%) ( < 0.0001). A dynamic acquisition was not necessary to assess this angle with neutral PRSA values yielding a sensitivity and specificity of 64-72% and 79-94% for the diagnosis of SLL tears. PRSA tended to increase with the severity of SLL tears and with the presence of scapholunate instability and yielded a good sensitivity and specificity for the detection of SLL tears.
Référence
AJR Am J Roentgenol. 2020 Jul 15;: