Abstract
Purpose:To evaluate the degree of joint distraction during direct MR arthrography with axial traction in sports injuries. To confirm the effect of axial traction on the quality of wrist opacification.Patients and methods:Seventeen patients (11 male, 6 female) underwent wrist MR arthrography without (mean: 39 years (SD 11.6))., and 20 patients (16 male, 4 female) with axial traction (mean: 28 years (SD 7.1)). Subgroups were defined according to pathology: degenerative, ligamentous, traumatic, normal (ie patients without MR-arthrography lesions). Radioscaphoid, radiolunate, lunocapitate, ulna Triangular Fibrocartilage (TFC), scapho-lunate, luno-triquetral, ulnocarpal, Carpo-Metacarpal (CMC) I and III and distal radio-ulnar spaces were measured for all patients. Differences in joint space width were compared between subgroups. Joint space opacification was subjectively scored from 0 (no opacification) to 3 (fully opacified), and compared between the groups with and without traction.Results:The difference in joint space was statistically significant (p<0.05) for radioscaphoid, radiolunate, lunocapitate and ulnocarpal spaces, but only in patients with ligamentous tears. Opacification score was significantly higher for ulnocarpal (p=0.0275) and CMC III joint spaces (p=0.0272) with axial traction.Conclusion:Axial traction resulted in a significantly higher radioscaphoid, radio-lunate, lunocapitate and ulnocarpal joint spaces width. This positive effect of axial traction raises the suspicion of sports ligamentous lesions.
Highlights
In the general population, sports related joint injury occurs most often on the knee (24.7%) and ankle (18.8%), whereas elbow and wrist together account for about 5.5 per cent [1]
Low impact sports like tennis, golf and basketball will more likely be responsible for nondisplaced fractures, contusions, stress reactions, ligamentous sprain or tenosynovitis [3]
Patients and Methods Study population The study population consisted of 37 consecutive patients who were referred to our imaging department by an orthopaedic surgeon, with the clinical suspicion of sports related wrist injury from September 2012 to December 2013
Summary
Sports related joint injury occurs most often on the knee (24.7%) and ankle (18.8%), whereas elbow and wrist together account for about 5.5 per cent [1]. Between 3 and 9 per cent of all sports injuries involve the hand or the wrist [2]. High impact sports such as auto racing, football, or alpine skiing will more often cause displaced fractures, dislocations, ligamentous and tendon tears. In the setting of sports-related wrist injury, the scaphoid is the most commonly fractured carpal bone, whereas ligamentous tears will occur mostly at the scapholunate ligament. In both cases, the injury mechanism is a fall on an outstretched hand. Ligamentous lesions are often initially missed [2]
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