Pedro Augusto Gondim Teixeira1,2, Sammy Badr3, Gabriela Hossu4, Guillaume Lefebvre3, Waled Abou Arab5, Alain Blum5, Anne Cotten3. 1. Service D'imagerie Guilloz, Hôpital Central, CHRU-Nancy, 54000, Nancy, France. ped_gt@hotmail.com. 2. Université de Lorraine, laboratoire IADI, UMR S 947, Nancy, France. ped_gt@hotmail.com. 3. Department of Radiology and Musculoskeletal Imaging, CHRU Lille Centre de Consultations et d'Imagerie de l'Appareil Locomoteur, 59037, Lille, France. 4. Université de Lorraine, laboratoire IADI, UMR S 947, Nancy, France. 5. Service D'imagerie Guilloz, Hôpital Central, CHRU-Nancy, 54000, Nancy, France.
Abstract
OBJECTIVE: To evaluate the feasibility and potential clinical applicability of speckle-tracking sonography for the dynamic evaluation of the scapholunate diastasis during stress manoeuvres. MATERIAL AND METHODS: Two readers used speckle tracking sonography to evaluate scapholunate diastasis during a clenching fist manoeuver in 30 normal wrists. Scapholunate peak strain, mean scapholunate diastasis and the diastasis variation coefficient were analysed. IRB exemption was granted for this study. Conventional and stress wrist radiographs of 26 patients with and without a scapholunate ligament tear were retrospectively analysed to ascertain the range of variation in scapholunate diastasis. RESULTS: Speckle-tracking parameters in normal wrists were similar between the two readers (p > 0.2061). The maximal scapholunate peak strain during stress was relatively low (<0.34-0.47 mm). The normal radiographic diastasis amplitude was similar to maximal strain peak values in normal volunteers (0.49 ± 0.51 mm). The radiographic diastasis amplitude in cases of scapholunate ligament tears was 1.48 ± 0.78 mm, which was higher than the 95% confidence interval of the scapholunate gap peak strain. CONCLUSION: Speckle-tracking sonography could represent an interesting alternative for stress evaluation of the scapholunate ligament in patients with scapholunate diastasis. KEY POINTS: • Speckle-tracking sonography can assess scapholunate diastasis under stress testing. • Scapholunate gap shows little variation under stress in healthy volunteers. • Scapholunate gap measurements are influenced by grip strength. • Sex and BMI have a significant influence on strain measurements.
OBJECTIVE: To evaluate the feasibility and potential clinical applicability of speckle-tracking sonography for the dynamic evaluation of the scapholunatediastasis during stress manoeuvres. MATERIAL AND METHODS: Two readers used speckle tracking sonography to evaluate scapholunatediastasis during a clenching fist manoeuver in 30 normal wrists. Scapholunate peak strain, mean scapholunatediastasis and the diastasis variation coefficient were analysed. IRB exemption was granted for this study. Conventional and stress wrist radiographs of 26 patients with and without a scapholunate ligament tear were retrospectively analysed to ascertain the range of variation in scapholunatediastasis. RESULTS: Speckle-tracking parameters in normal wrists were similar between the two readers (p > 0.2061). The maximal scapholunate peak strain during stress was relatively low (<0.34-0.47 mm). The normal radiographic diastasis amplitude was similar to maximal strain peak values in normal volunteers (0.49 ± 0.51 mm). The radiographic diastasis amplitude in cases of scapholunate ligament tears was 1.48 ± 0.78 mm, which was higher than the 95% confidence interval of the scapholunate gap peak strain. CONCLUSION: Speckle-tracking sonography could represent an interesting alternative for stress evaluation of the scapholunate ligament in patients with scapholunatediastasis. KEY POINTS: • Speckle-tracking sonography can assess scapholunatediastasis under stress testing. • Scapholunate gap shows little variation under stress in healthy volunteers. • Scapholunate gap measurements are influenced by grip strength. • Sex and BMI have a significant influence on strain measurements.
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