The authors studied 103 wrists with suspected tears of the scapholunate interosseous ligament by magnetic resonance imaging (MRI) and diagnostic arthroscopy. The MR images were obtained with a 1.0-T scanner and a ring surface coil. Two mm slices were completed through the carpus with intravenous contrast and 2 mm and 3 mm slices were completed without intravenous contrast. Arthroscopy was performed through both the radiocarpal and midcarpal intervals for verification of the scapholunate interosseous ligament injury. No differentiation was made between partial and complete tears. A correct diagnosis of a scapholunate interosseous ligament injury by MRI was made in only 75% of cases with an overall sensitivity of 63% and a specificity of 86%. There was no improvement in accuracy with the use of intravenous contrast. The authors conclude that MRI is not useful in detecting injury to the scapholunate interosseous ligament.
This study is another to identify the difficulty in detecting signal change in the interosseous ligaments of the wrist. MRI appears to lack sensitivity and specificity in this regard. With improvements in magnet strength, the use of dedicated surface coils and thinner sections, and the administration of intraarticular contrast agents (Gadolinium), MRI may ultimately allow improved visualization of the scapholunate and other intrinsic and extrinsic ligament injuries about the wrist.