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European Radiology
Published in: European Radiology 11/2022

21-04-2022 | Computed Tomography | Musculoskeletal

Kinematic 4D CT case-control study of wrist in dart throwing motion “in vivo”: comparison with other maneuvers

Authors: Sinan Orkut, Romain Gillet, Gabriela Hossu, Charles Lombard, Alain Blum, Lionel Athlani, Pedro Augusto Gondim Teixeira

Published in: European Radiology | Issue 11/2022

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Abstract

Objectives

To compare the diagnostic performance of scapholunate gap (SLG) measurements acquired with dart throwing (DT), radio-ulnar deviation (RUD), and clenching fist (CF) maneuvers on 4D CT for the identification of scapholunate instability.

Methods

In this prospective study, 47 patients with suspected scapholunate interosseous ligament (SLIL) tears were evaluated from March 2015 to March 2020 with semiautomatic quantitative analysis on 4D CT. Five parameters (median, maximal value, range, and coefficient of variation) for SLG, lunocapitate angle (LCA), and radioscaphoid angle (RSA) obtained during DT maneuver were evaluated in patients with and without SLIL tears. CT arthrography was used as the gold standard for the SLIL status. The SLG values obtained were also compared with those obtained during CF and RUD maneuvers.

Results

Significant differences in all SLG- and LCA-derived parameters are found between patients with and without SLIL tears with DT (p < 0.003). The best diagnostic performance for the diagnosis of SLIL tears was obtained with median and maximal SLG values (sensitivity and specificity of 86–89% and 95%) and with maximal and range LCA values (sensitivity and specificity of 86% and 74%). No significant differences were observed for RSA values (p > 0.275). The SLG range obtained with DT maneuver was the only dynamic parameter statistically different between patients with partial and complete torn SLIL (p = 0.037).

Conclusion

4D CT of the wrist during DT showed a similar performance than RUD and a better performance than CF for the differentiation between patients with and without SLIL tears.

Key Points

• Four-dimensional computed tomography can dynamically assess scapholunate instability.
• The best results for differentiating between patients with and without SLIL tears were obtained with SLG median and maximal values.
• The dart throwing and radio-ulnar deviation maneuvers yielded the best results for the dynamic evaluation of scapholunate instability.
Appendix
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Metadata
Title
Kinematic 4D CT case-control study of wrist in dart throwing motion “in vivo”: comparison with other maneuvers
Authors
Sinan Orkut
Romain Gillet
Gabriela Hossu
Charles Lombard
Alain Blum
Lionel Athlani
Pedro Augusto Gondim Teixeira
Publication date
21-04-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08746-y

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