Wrist cineradiography: a protocol for diagnosing carpal instability

Abstract

Carpal instability is often related to ruptured or lax carpal ligaments. Wrist cineradiography has been shown to be a good modality for diagnosing carpal instability. To create uniformity in obtaining and assessing wrist cineradiography, a wrist cineradiography protocol is desirable. This protocol will focus on wrist cineradiography for diagnosing carpal instabilities. It describes the pathologic motions of the carpus and correlates these with a clinical diagnosis.

Level of evidence: III.

Keywords: Carpal instability; fluoroscopy; scapholunate dissociation; scapholunate ligament; wrist cineradiography.

Figure 1.

Conventional radiography, PA view. Suspected static SLD.

Figure 2.

Adaptive CIND. In patients with a dorsally displaced distal radius fracture, the increased inclination can be compensated by a relative flexion of the capitate. In this movement the capitate is collinear with the radius, but dorsal to the longitudinal axis of the radius (a). Alternatively, the lunate can be rotated palmarly to compensate for the increased inclination of the distal radial joint surface. The capitate is collinear with the lunate, but dorsal to the longitudinal axis of the radius (b).