Evaluation of prestyloid recess morphology and ulnar-sided contrast leakage in CT arthrography of the wrist

Please always quote using this URN: urn:nbn:de:bvb:20-opus-301113
  • 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 (40Background 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.show moreshow less

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Metadaten
Author: Carsten Herbert Gietzen, Andreas Steven Kunz, Karsten Sebastian Luetkens, Henner Huflage, Georgios Christopoulos, Jörg van Schoonhoven, Thorsten Alexander Bley, Rainer Schmitt, Jan-Peter Grunz
URN:urn:nbn:de:bvb:20-opus-301113
Document Type:Journal article
Faculties:Medizinische Fakultät / Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik)
Language:English
Parent Title (English):BMC Musculoskeletal Disorders
Year of Completion:2022
Volume:23
Issue:1
Article Number:284
Source:BMC Musculoskeletal Disorders 2022, 23(1):284. DOI: 10.1186/s12891-022-05241-9
DOI:https://doi.org/10.1186/s12891-022-05241-9
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:arthrography; prestyloid recess; tomography; triangular fibrocartilage complex; x-ray computed
Release Date:2023/03/10
Collections:Open-Access-Publikationsfonds / Förderzeitraum 2022
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International