Skip to main content
Top
Published in: Skeletal Radiology 9/2005

01-09-2005 | Scientific Article

Ultrasonographic evaluation of normal extrinsic and intrinsic carpal ligaments: preliminary experience

Authors: Nathalie Boutry, Franck Lapegue, Laetitia Masi, Antoine Claret, Xavier Demondion, Anne Cotten

Published in: Skeletal Radiology | Issue 9/2005

Login to get access

Abstract

Objective

To determine normal anatomy of extrinsic and intrinsic carpal ligaments at ultrasonography (US).

Design and volunteers

In the first part of the study, two musculoskeletal radiologists retrospectively reviewed in consensus the photographs of anatomic sections and dissections derived from 20 cadaveric wrists. This cadaveric study gave the two readers the opportunity to learn the anatomy and orientation of the various extrinsic and intrinsic carpal ligaments and, thus, to develop a US protocol to facilitate the recognition of each carpal ligament. In the second part of the study, these two radiologists prospectively and independently evaluated the visibility of extrinsic and intrinsic carpal ligaments in 30 wrists of volunteers, using the same US protocol.

Results

With regard to extrinsic carpal ligaments, the radioscaphocapitate ligament (partially visible, 38%; completely visible, 62%), the radiolunotriquetral ligament (partially visible, 27%; completely visible, 73%), the palmar ulnotriquetral ligament (partially visible, 12%; completely visible, 88%), and the dorsal radiotriquetral ligament (partially visible, 7%; completely visible, 93%) were visualized at US. The dorsal ulnotriquetral ligament (partially visible, 21%; completely visible, 74%), the ulnolunate ligament (partially visible, 5%; completely visible, 70%), and the radial collateral ligament (partially visible, 18%; completely visible, 12%) were more difficult to recognize. The radioscapholunate ligament was never seen. With regard to intrinsic carpal ligaments, the dorsal (partially visible, 11%; completely visible, 89%) and palmar (partially visible, 38%; completely visible, 62%) scaphotriquetral ligaments as well as the dorsal scapholunate ligament (partially visible, 3%; completely visible, 97%) were visualized at US. The dorsal lunotriquetral ligament (partially visible, 39%; completely visible, 61%) and the palmar scapholunate ligaments (partially visible, 12%; completely visible, 81%) were more difficult to recognize.

Conclusion

US may be helpful in identifying the major extrinsic and intrinsic carpal ligaments.
Literature
1.
go back to reference Theumann N, Favarger N, Schnyder P, Meuli R. Wrist ligament injuries: value of post-arthrography computed tomography. Skeletal Radiol 2001; 30:88–93.CrossRefPubMed Theumann N, Favarger N, Schnyder P, Meuli R. Wrist ligament injuries: value of post-arthrography computed tomography. Skeletal Radiol 2001; 30:88–93.CrossRefPubMed
2.
go back to reference Totterman SM, Miller R, Wasserman B, Blebea JS, Rubens DJ. Intrinsic and extrinsic carpal ligaments: evaluation by three-dimensional Fourier transform MR imaging. AJR Am J Roentgenol 1993; 160:117–123.PubMed Totterman SM, Miller R, Wasserman B, Blebea JS, Rubens DJ. Intrinsic and extrinsic carpal ligaments: evaluation by three-dimensional Fourier transform MR imaging. AJR Am J Roentgenol 1993; 160:117–123.PubMed
3.
go back to reference Smith DK. Volar carpal ligaments of the wrist: normal appearance on multiplanar reconstructions of three-dimensional Fourier transform MR imaging. AJR Am J Roentgenol 1993; 161:353–357.PubMed Smith DK. Volar carpal ligaments of the wrist: normal appearance on multiplanar reconstructions of three-dimensional Fourier transform MR imaging. AJR Am J Roentgenol 1993; 161:353–357.PubMed
4.
go back to reference Smith DK. Dorsal carpal ligaments of the wrist: normal appearance on multiplanar reconstructions of three-dimensional Fourier transform MR imaging. AJR Am J Roentgenol 1993; 161:119–125.PubMed Smith DK. Dorsal carpal ligaments of the wrist: normal appearance on multiplanar reconstructions of three-dimensional Fourier transform MR imaging. AJR Am J Roentgenol 1993; 161:119–125.PubMed
5.
go back to reference Timins ME, Jahnke JP, Krah SF, Erickson SJ, Carrera GF. MR imaging of the major carpal stabilizing ligaments: normal anatomy and clinical examples. Radiographics 1995; 15:575–587.PubMed Timins ME, Jahnke JP, Krah SF, Erickson SJ, Carrera GF. MR imaging of the major carpal stabilizing ligaments: normal anatomy and clinical examples. Radiographics 1995; 15:575–587.PubMed
6.
go back to reference Brown RR, Fliszar E, Cotten A, Trudell D, Resnick D. Extrinsic and intrinsic ligaments of the wrist: normal and pathologic anatomy at MR arthrography with three-compartment enhancement. Radiographics 1998; 18:667–674.PubMed Brown RR, Fliszar E, Cotten A, Trudell D, Resnick D. Extrinsic and intrinsic ligaments of the wrist: normal and pathologic anatomy at MR arthrography with three-compartment enhancement. Radiographics 1998; 18:667–674.PubMed
7.
go back to reference Theumann NH, Pfirrmann CWA, Antonio GE, Chung CB, Gilula LA, Trudell DJ, Resnick D. Extrinsic carpal ligaments: normal MR arthrographic appearance in cadavers. Radiology 2003; 226:171–179.PubMed Theumann NH, Pfirrmann CWA, Antonio GE, Chung CB, Gilula LA, Trudell DJ, Resnick D. Extrinsic carpal ligaments: normal MR arthrographic appearance in cadavers. Radiology 2003; 226:171–179.PubMed
8.
go back to reference Griffith JF, Chan DP, Ho PC, Zhao L, Hung LK, Metreweli C. Sonography of the normal scapholunate ligament and scapholunate joint space. J Clin Ultrasound 2001; 29:223–229.PubMed Griffith JF, Chan DP, Ho PC, Zhao L, Hung LK, Metreweli C. Sonography of the normal scapholunate ligament and scapholunate joint space. J Clin Ultrasound 2001; 29:223–229.PubMed
9.
go back to reference Jacobson JA, Oh E, Propeck T, Jebson PJL, Jamadar DA, Hayes CW. Sonography of the scapholunate ligament in four cadaveric wrists: correlation with MR arthrography and anatomy. AJR Am J Roentgenol 2002; 179:523–527.PubMed Jacobson JA, Oh E, Propeck T, Jebson PJL, Jamadar DA, Hayes CW. Sonography of the scapholunate ligament in four cadaveric wrists: correlation with MR arthrography and anatomy. AJR Am J Roentgenol 2002; 179:523–527.PubMed
10.
go back to reference Finlay K, Lee R, Friedman L. Ultrasound of intrinsic wrist ligament and triangular fibrocartilage injuries. Skeletal Radiol 2004; 33:85–90.PubMed Finlay K, Lee R, Friedman L. Ultrasound of intrinsic wrist ligament and triangular fibrocartilage injuries. Skeletal Radiol 2004; 33:85–90.PubMed
11.
go back to reference Keogh CF, Wong AD, Wells NJ, Barbarie JE, Cooperberg PL. High-resolution sonography of the triangular fibrocartilage: initial experience and correlation with MRI and arthroscopic findings. AJR Am J Roentgenol 2004; 182:333–336.PubMed Keogh CF, Wong AD, Wells NJ, Barbarie JE, Cooperberg PL. High-resolution sonography of the triangular fibrocartilage: initial experience and correlation with MRI and arthroscopic findings. AJR Am J Roentgenol 2004; 182:333–336.PubMed
12.
go back to reference Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33:159–174.PubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33:159–174.PubMed
13.
go back to reference Sennwald GR, et al. The anatomy of the palmar scaphotriquetral ligament. J Bone Joint Surg Br 1994; 76:147–149.PubMed Sennwald GR, et al. The anatomy of the palmar scaphotriquetral ligament. J Bone Joint Surg Br 1994; 76:147–149.PubMed
14.
go back to reference Yin Y, Evanoff B, Gilula LA, Pilgram TK. Evaluation of selective wrist arthrography of contralateral asymptomatic wrists for symmetric ligamentous defects. AJR Am J Roentgenol 1996; 166:1067–1073.PubMed Yin Y, Evanoff B, Gilula LA, Pilgram TK. Evaluation of selective wrist arthrography of contralateral asymptomatic wrists for symmetric ligamentous defects. AJR Am J Roentgenol 1996; 166:1067–1073.PubMed
15.
go back to reference Wright TW, Del Charco M, Wheeler D. Incidence of ligament lesions and associated degenerative changes in the elderly wrist. J Hand Surg [Am] 1994; 19:313–318. Wright TW, Del Charco M, Wheeler D. Incidence of ligament lesions and associated degenerative changes in the elderly wrist. J Hand Surg [Am] 1994; 19:313–318.
16.
go back to reference Berger RA. The gross and histologic anatomy of the scapholunate interosseous ligament. J Hand Surg [Am] 1996; 21: 170–178. Berger RA. The gross and histologic anatomy of the scapholunate interosseous ligament. J Hand Surg [Am] 1996; 21: 170–178.
17.
go back to reference Li G, Rowen B, Tokunaga D, Ryu J, Kato H, Kihira M. Carpal kinematics of lunotriquetral dissociations. Biomed Sci Instrum 1991; 27:273–281.PubMed Li G, Rowen B, Tokunaga D, Ryu J, Kato H, Kihira M. Carpal kinematics of lunotriquetral dissociations. Biomed Sci Instrum 1991; 27:273–281.PubMed
18.
go back to reference Linscheid RL, Dobyns JH. Dynamic carpal instability. Keio J Med 2002; 51:140–147.PubMed Linscheid RL, Dobyns JH. Dynamic carpal instability. Keio J Med 2002; 51:140–147.PubMed
19.
go back to reference Berger RA, Kauer JM, Landsmeer JM. Radioscapholunate ligament: a gross anatomic and histologic study of fetal and adult wrists. J Hand Surg [Am] 1991; 16:350–355. Berger RA, Kauer JM, Landsmeer JM. Radioscapholunate ligament: a gross anatomic and histologic study of fetal and adult wrists. J Hand Surg [Am] 1991; 16:350–355.
20.
go back to reference Sonography of the elbow, wrist, and hand. van Holsbeeck M, Introcaso JH. Musculoskeletal Ultrasound, 2nd edn. Mosby, 2001. 517–571. Sonography of the elbow, wrist, and hand. van Holsbeeck M, Introcaso JH. Musculoskeletal Ultrasound, 2nd edn. Mosby, 2001. 517–571.
Metadata
Title
Ultrasonographic evaluation of normal extrinsic and intrinsic carpal ligaments: preliminary experience
Authors
Nathalie Boutry
Franck Lapegue
Laetitia Masi
Antoine Claret
Xavier Demondion
Anne Cotten
Publication date
01-09-2005
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 9/2005
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-005-0929-4

Other articles of this Issue 9/2005

Skeletal Radiology 9/2005 Go to the issue