TY  - JOUR
A1  - Gietzen, Carsten Herbert
A1  - Kunz, Andreas Steven
A1  - Luetkens, Karsten Sebastian
A1  - Huflage, Henner
A1  - Christopoulos, Georgios
A1  - van Schoonhoven, Jörg
A1  - Bley, Thorsten Alexander
A1  - Schmitt, Rainer
A1  - Grunz, Jan-Peter
T1  - Evaluation of prestyloid recess morphology and ulnar-sided contrast leakage in CT arthrography of the wrist
JF  - BMC Musculoskeletal Disorders
N2  - Background
In wrist arthrograms, aberrant contrast material is frequently seen extending into the soft tissue adjacent to the ulnar styloid process. Since the prestyloid recess can mimic contrast leakage in CT arthrography, this study aims to provide a detailed analysis of its morphologic variability, while investigating whether actual ulnar-sided leakage is associated with injuries of the triangular fibrocartilage complex (TFCC).
Methods
Eighty-six patients with positive wrist trauma history underwent multi-compartment CT arthrography (40 women, median age 44.5 years). Studies were reviewed by two board-certified radiologists, who documented the morphology of the prestyloid recess regarding size, opening type, shape and position, as well as the presence or absence of ulnar-sided contrast leakage. Correlations between leakage and the presence of TFCC injuries were assessed using the mean square contingency coefficient (r\(_{ɸ}\)).
Results
The most common configuration of the prestyloid recess included a narrow opening (73.26%; width 2.26 ± 1.43 mm), saccular shape (66.28%), and palmar position compared to the styloid process (55.81%). Its mean length and anterior–posterior diameter were 6.89 ± 2.36 and 5.05 ± 1.97 mm, respectively. Ulnar-sided contrast leakage was reported in 29 patients (33.72%) with a mean extent of 12.30 ± 5.31 mm. Leakage occurred more often in patients with ulnar-sided TFCC injuries (r\(_{ɸ}\) = 0.480; p < 0.001), whereas no association was found for lesions of the central articular disc (r\(_{ɸ}\) = 0.172; p = 0.111).
Conclusions
Since ulnar-sided contrast leakage is more common in patients with peripheral TFCC injuries, distinction between an atypical configuration of the prestyloid recess and actual leakage is important in CT arthrography of the wrist.
KW  - prestyloid recess
KW  - arthrography
KW  - tomography
KW  - x-ray computed
KW  - triangular fibrocartilage complex
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-301113
VL  - 23
IS  - 1
ER  - 
TY  - JOUR
A1  - Huflage, Henner
A1  - Karsten, Sebastian
A1  - Kunz, Andreas Steven
A1  - Conrads, Nora
A1  - Jakubietz, Rafael Gregor
A1  - Jakubietz, Michael Georg
A1  - Pennig, Lenhard
A1  - Goertz, Lukas
A1  - Bley, Thorsten Alexander
A1  - Schmitt, Rainer
A1  - Grunz, Jan-Peter
T1  - Improved diagnostic accuracy for ulnar-sided TFCC lesions with radial reformation of 3D sequences in wrist MR arthrography
JF  - European Radiology
N2  - Objectives
Triangular fibrocartilage complex (TFCC) injuries frequently cause ulnar-sided wrist pain and can induce distal radioulnar joint instability. With its complex three-dimensional structure, diagnosis of TFCC lesions remains a challenging task even in MR arthrograms. The aim of this study was to assess the added diagnostic value of radial reformatting of isotropic 3D MRI datasets compared to standard planes after direct arthrography of the wrist.
Methods
Ninety-three patients underwent wrist MRI after fluoroscopy-guided multi-compartment arthrography. Two radiologists collectively analyzed two datasets of each MR arthrogram for TFCC injuries, with one set containing standard reconstructions of a 3D thin-slice sequence in axial, coronal and sagittal orientation, while the other set comprised an additional radial plane view with the rotating center positioned at the ulnar styloid. Surgical reports (whenever available) or radiological reports combined with clinical follow-up served as a standard of reference. In addition, diagnostic confidence and assessability of the central disc and ulnar-sided insertions were subjectively evaluated.
Results
Injuries of the articular disc, styloid and foveal ulnar attachment were present in 20 (23.7%), 10 (10.8%) and 9 (9.7%) patients. Additional radial planes increased diagnostic accuracy for lesions of the styloid (0.83 vs. 0.90; p = 0.016) and foveal (0.86 vs. 0.94; p = 0.039) insertion, whereas no improvement was identified for alterations of the central cartilage disc. Readers' confidence (p < 0.001) and assessability of the ulnar-sided insertions (p < 0.001) were superior with ancillary radial reformatting.
Conclusions
Access to the radial plane view of isotropic 3D sequences in MR arthrography improves diagnostic accuracy and confidence for ulnar-sided TFCC lesions.
KW  - joint instability
KW  - wrist
KW  - arthrography
KW  - magnetic resonance imaging
KW  - triangular fibrocartilage
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-266512
SN  - 1432-1084
VL  - 31
IS  - 12
ER  -