Inter-Rater Reliability of Magnetic Resonance Imaging in Comparison to Computed Tomography and Wrist Arthroscopy in SLAC and SNAC Wrist.

Athanasios Terzis,Arlena Klinger,Jessica Seegmüller,Michael Sauerbier

doi:10.3390/jcm10163592

Abstract

The aim of the study was to assess the inter-rater reliability of magnetic resonance imaging (MRI) in comparison to computed tomography (CT) and wrist arthroscopy in patients with scapholunate (SLAC) or scaphoid non-union advanced collapse (SNAC) as well as to evaluate a grading score of cartilage lesions. A total of 42 patients (36 male, 6 female) at a mean age of 45 years (range: 19–65 years) with a SLAC or SNAC wrist who had a preoperative MRI and CT scan as well as underwent arthroscopy of the wrist between 2013 and 2018 were included in this study. Cartilage lesions, as assessed by MRI, CT and wrist arthroscopy, were classified by two hand surgeons in three stages. Inter-rater reliability was evaluated using the Kendall Tau-b test as well as the chi-square test to analyze for trend. The correlation between cartilage lesions, classified by arthroscopy and MRI, was low. A moderate correlation between CT and arthroscopy staging was shown. The highest inter-rater correlation was found between MRI and CT staging. An additionally performed logistic regression showed that progression of cartilage lesions as shown in MRI scans correlates with a restriction of range of motion (ROM). The level of cartilage lesion may be more severely classified in an MRI than during arthroscopy. Arthroscopy remains the gold standard in detecting cartilage lesions and thus in the decision-making process of the definitive treatment in carpal collapse.

Highlights

Scaphoid non-unions as well as untreated injuries of the scapholunate ligament can alter the anatomy and biomechanics of the wrist and may develop into advanced carpal collapse [1,2,3,4]
A preoperative magnetic resonance imaging (MRI) scan was performed in all 42 patients, whilst a preoperative computed tomography (CT) scan was performed in 26 patients (61.9%)
The results of this study show that the MRI is a useful diagnostic tool for cartilage The results of thiswith studySNAC

Summary

Introduction

Scaphoid non-unions as well as untreated injuries of the scapholunate ligament can alter the anatomy and biomechanics of the wrist and may develop into advanced carpal collapse [1,2,3,4]. Staging of cartilage degeneration may be assessed by magnetic resonance imaging (MRI). MRI is primarily intended to detect a scapholunate ligament tear [10,11] or to examine the blood perfusion of the scaphoid non-union [12]. It is a suitable method for mapping the hyaline cartilage of a joint [13]. There is no established MRI classification for degeneration of carpal cartilage [14]

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