The value of multi-detector CT arthrography of the wrist joint in evaluation of ligamentous and capsular injuries in post-traumatic pain

The wrist joint is a complex joint containing several intrinsic and extrinsic ligaments that contribute to carpal stability. There is increased incidence of ligamentous/capsular injury following trauma. Objective: The aim of this study was to assess the value of high resolution MDCT arthrography in detection of various ligamentous and capsular injuries of the wrist in post-traumatic writ pain. Patients and methods: From August 2016 to February 2017 Seventeen patients with posttraumatic wrist pain underwent MDCT arthrography primarily through radiocarpal injection and using high resolution study, all patients have negative MRI study of the wrist. Results: 59% of cases had ligamentous/capsular tear. The most frequent was the capsular tears. Incomplete intrinsic ligament tears were observed, the dorsal scaphotrapezio-trapezoid ligament was the commonest to be affected. Class IA traumatic TFC tear was found in 12%. There was significant high positive correlation between the VAS score for wrist pain and the presence of ligamentous/capsular tear in absence of bone fracture. Conclusion: MDCT arthrography of the wrist is an excellent imaging method that can detect MRI occult ligamentous tear in unexplained post traumatic pain.