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BMC Musculoskeletal Disorders

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Open Access 01-12-2021 | Computed Tomography | Study protocol

ACTION trial: a prospective study on diagnostic Accuracy of 4D CT for diagnosing Instable ScaphOlunate DissociatioN

Authors: Leonie Goelz, Simon Kim, Claas Güthoff, Frank Eichenauer, Andreas Eisenschenk, Sven Mutze, Ariane Asmus

Published in: BMC Musculoskeletal Disorders | Issue 1/2021

Abstract

Background

Early detection of scapholunate ligament (SLL) tears is essential after minor and major trauma to the wrist. The differentiation between stable and instable injuries determines therapeutic measures which aim to prevent osteoarthritis. Arthroscopy has since been the diagnostic gold standard in suspected SLL tears because non-invasive methods have failed to exclude instable injuries reliably. This prospective study aims to determine the diagnostic accuracy of dynamic, 4D computed tomography (CT) of the wrist for diagnosing instable SLL tears.

Methods

Single center, prospective trial including 40 patients with suspected SLL tears scheduled for arthroscopy. Diagnostic accuracy of 4D CT will be tested against the reference standard arthroscopy. Radiologists will be blinded to the results of arthroscopy and hand surgeons to radiological reports. A historical cohort of 80 patients which was diagnosed using cineradiography before implementation of 4D CT at the study site will serve as a comparative group.

Discussion

Static imaging lacks the ability to detect instable SLL tears after wrist trauma. Dynamic methods such as cineradiography and dynamic magnetic resonance imaging (MRI) are complex and require specific technical infrastructure in specialized centers. Modern super-fast dual source CT scanners are gaining popularity and are being installed gradually in hospitals and ambulances. These scanners enable dynamic imaging in a quick and simple manner. Establishment of dynamic 4D CT of the wrist in patients with suspected SLL tears in in- and outpatient settings could improve early detection rates. Reliable identification of instable injuries through 4D CT scans might reduce the number of unnecessary diagnostic arthroscopies in the future.

Trial registration

This study was registered prospectively at the German Clinical Trials Register (DRKS) DRKS00021110. Universal Trial Number (WHO-UTN): U1111–1249-7884.

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Title: ACTION trial: a prospective study on diagnostic Accuracy of 4D CT for diagnosing Instable ScaphOlunate DissociatioN
Authors: Leonie Goelz
Simon Kim
Claas Güthoff
Frank Eichenauer
Andreas Eisenschenk
Sven Mutze
Ariane Asmus
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Computed Tomography
Computed Tomography
Arthroscopy
Arthroscopy
Published in: BMC Musculoskeletal Disorders / Issue 1/2021
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-021-03946-x

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ACTION trial: a prospective study on diagnostic Accuracy of 4D CT for diagnosing Instable ScaphOlunate DissociatioN

Abstract

Background

Methods

Discussion

Trial registration

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Abstract

Background

Methods

Discussion

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