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Ferreira Branco D, Botti P, Bouvet C, Abs B, Buzzi M, Beaulieu JY, Poletti PA, Bouredoucen H, Boudabbous S. Dorsal wrist ganglion: clinical and imaging correlation in symptomatic population based on high-field MRI. Eur Radiol 2024:10.1007/s00330-024-10831-3. [PMID: 38856779 DOI: 10.1007/s00330-024-10831-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 04/26/2024] [Accepted: 05/21/2024] [Indexed: 06/11/2024]
Abstract
OBJECTIVES To determine prevalence in the symptomatic population of dorsal mucoid cysts centered on dorsal capsuloscapholunate septum (DCSS) using high-field magnetic resonance imaging (MRI) for anatomoclinical and epidemiological correlations. MATERIALS AND METHODS This single-center retrospective study analyzed all 3-Tesla MRIs consecutively performed for painful wrists in 295 patients. Two blinded readers performed measurements. The protocol included T1 spin echo and 3D proton density sequences with fat saturation. Inter-observer reliability was assessed using kappa and intra-class correlation coefficients for cyst detection and volumetry, respectively. Disagreements concerning cyst detection were resolved by a consensus reading. Cyst size, relationship to extrinsic and scapholunate ligaments (SL), continuity of SL, minimum distance to the posterior interosseous nerve (PIN), cyst communication with joint, and anatomical classifications of cysts were analyzed. Correlation tests were performed to assess associations. RESULTS Two-hundred ninety-five patients (mean age 39.6 +/- 15.6 (standard deviation), 161 males) were evaluated for detection of dorsal wrist cysts identified in 150/295. In this subgroup, the mean age was 38.7 years (15-75), the sex ratio of 0.6 (59% women), and the median volume cyst of 8.7 mm3 (0.52-2555). Cyst detection, volume, and major axis measurements showed very high agreement between observers, respectively, 0.89, 0.96, and 0.91. 42 patients had dorsal SL pain. A weak negative correlation was found between distance to PIN and dorsal SL pain (r = -0.2415; p < 0.05) and a weak positive correlation between Guérini's classification and dorsal SL pain (r = 0.2466; p < 0.05). CONCLUSION High-field MRI is the modality of choice for the detection, anatomical, and volumetric assessment of dorsal cysts. Preoperative assessment will be aided by the proposed revised anatomical classification. CLINICAL RELEVANCE STATEMENT High-field MRI is the modality of choice for the anatomical study of dorsal ganglion cysts. It allows the radiologist to accurately describe the anatomical relationships, size, and visibility of the pedicle, essential information for the surgeon's preoperative assessment. KEY POINTS Dorsal mucoid wrist ganglion is a condition for which prevalence remains to be determined. High-field MRI is a reproducible imaging modality for the detection and assessment of dorsal wrist cysts. High-field MRI has a key role in the preoperative management of dorsal mucoid cysts.
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Affiliation(s)
- David Ferreira Branco
- Diagnostic Department, Radiology Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland.
| | - Paul Botti
- Diagnostic Department, Radiology Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland
| | - Cindy Bouvet
- Orthopedic and Traumatology Surgery Department, Hand Surgery Unit, Sion Hospital, Av. du Grand-Champsec 80, 1951, Sion, Switzerland
| | - Bilal Abs
- Diagnostic Department, Radiology Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland
| | - Marcello Buzzi
- Diagnostic Department, Radiology Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland
| | - Jean Yves Beaulieu
- Orthopedic and Traumatology Surgery Department, Hand Surgery Unit, Sion Hospital, Av. du Grand-Champsec 80, 1951, Sion, Switzerland
| | - Pierre-Alexandre Poletti
- Diagnostic Department, Radiology Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland
| | - Hicham Bouredoucen
- Diagnostic Department, Radiology Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland
| | - Sana Boudabbous
- Diagnostic Department, Radiology Unit, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Switzerland
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Dietrich TJ, Toms AP, Cerezal L, Omoumi P, Boutin RD, Fritz J, Schmitt R, Shahabpour M, Becce F, Cotten A, Blum A, Zanetti M, Llopis E, Bień M, Lalam RK, Afonso PD, Mascarenhas VV, Sutter R, Teh J, Pracoń G, de Jonge MC, Drapé JL, Mespreuve M, Bazzocchi A, Bierry G, Dalili D, Garcia-Elias M, Atzei A, Bain GI, Mathoulin CL, Del Piñal F, Van Overstraeten L, Szabo RM, Camus EJ, Luchetti R, Chojnowski AJ, Grünert JG, Czarnecki P, Corella F, Nagy L, Yamamoto M, Golubev IO, van Schoonhoven J, Goehtz F, Klich M, Sudoł-Szopińska I. Interdisciplinary consensus statements on imaging of scapholunate joint instability. Eur Radiol 2021; 31:9446-9458. [PMID: 34100996 PMCID: PMC8589813 DOI: 10.1007/s00330-021-08073-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/12/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Objectives The purpose of this agreement was to establish evidence-based consensus statements on imaging of scapholunate joint (SLJ) instability by an expert group using the Delphi technique. Methods Nineteen hand surgeons developed a preliminary list of questions on SLJ instability. Radiologists created statements based on the literature and the authors’ clinical experience. Questions and statements were revised during three iterative Delphi rounds. Delphi panellists consisted of twenty-seven musculoskeletal radiologists. The panellists scored their degree of agreement to each statement on an eleven-item numeric scale. Scores of ‘0’, ‘5’ and ‘10’ reflected complete disagreement, indeterminate agreement and complete agreement, respectively. Group consensus was defined as a score of ‘8’ or higher for 80% or more of the panellists. Results Ten of fifteen statements achieved group consensus in the second Delphi round. The remaining five statements achieved group consensus in the third Delphi round. It was agreed that dorsopalmar and lateral radiographs should be acquired as routine imaging work-up in patients with suspected SLJ instability. Radiographic stress views and dynamic fluoroscopy allow accurate diagnosis of dynamic SLJ instability. MR arthrography and CT arthrography are accurate for detecting scapholunate interosseous ligament tears and articular cartilage defects. Ultrasonography and MRI can delineate most extrinsic carpal ligaments, although validated scientific evidence on accurate differentiation between partially or completely torn or incompetent ligaments is not available. Conclusions Delphi-based agreements suggest that standardized radiographs, radiographic stress views, dynamic fluoroscopy, MR arthrography and CT arthrography are the most useful and accurate imaging techniques for the work-up of SLJ instability. Key Points • Dorsopalmar and lateral wrist radiographs remain the basic imaging modality for routine imaging work-up in patients with suspected scapholunate joint instability. • Radiographic stress views and dynamic fluoroscopy of the wrist allow accurate diagnosis of dynamic scapholunate joint instability. • Wrist MR arthrography and CT arthrography are accurate for determination of scapholunate interosseous ligament tears and cartilage defects.
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Affiliation(s)
- Tobias Johannes Dietrich
- Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, Rorschacherstrasse 95, CH 9007, St. Gallen, Switzerland. .,Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland.
| | - Andoni Paul Toms
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Luis Cerezal
- Radiology Department, DMC-Diagnóstico Médico Cantabria, Castilla 6-Bajo, 39002, Santander, Spain
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Robert Downey Boutin
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, MC-5105, Stanford, CA, 94305, USA
| | - Jan Fritz
- Department of Radiology, New York University Grossman School of Medicine, NYU Langone Health, 660 First Avenue, New York, NY, 10016, USA
| | - Rainer Schmitt
- Klinikum der Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Radiologie, Marchioninistraße 15, D-81377, München, Germany
| | - Maryam Shahabpour
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Fabio Becce
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011, Lausanne, Switzerland
| | - Anne Cotten
- Service de Radiologie et Imagerie Musculosquelettique, CCIAL, CHU de Lille, 59800, Lille, France
| | - Alain Blum
- Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, UDL, 29 avenue du Maréchal de Lattre de Tassigny, 54035, Nancy, France
| | - Marco Zanetti
- Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland.,Department of Musculoskeletal Radiology, Clinic Hirslanden Zurich, Witellikerstrasse 40, 8008, Zurich, Switzerland
| | - Eva Llopis
- Hospital de la Ribera, IMSKE, Valencia, Paseo Ciudadela 13, 46003, Valencia, Spain
| | - Maciej Bień
- Gamma Medical Center, Broniewskiego 3, 01-785, Warsaw, Poland
| | - Radhesh Krishna Lalam
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - P Diana Afonso
- Musculoskeletal Imaging Unit, Imaging Center, Radiology Department, Hospital da Luz, Grupo Luz Saúde, Av. Lusiada 100, 1500-650, Lisbon, Portugal.,Hospital Particular da Madeira, HPA, Funchal, Madeira, Portugal
| | - Vasco V Mascarenhas
- Musculoskeletal Imaging Unit, Imaging Center, Radiology Department, Hospital da Luz, Grupo Luz Saúde, Av. Lusiada 100, 1500-650, Lisbon, Portugal.,AIRC, Advanced Imaging Research Consortium, Lisbon, Portugal
| | - Reto Sutter
- Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland.,Radiology, Balgrist University Hospital, University of Zurich, Forchstrasse 340, CH-8008, Zurich, Switzerland
| | - James Teh
- Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Grzegorz Pracoń
- Gamma Medical Center, Broniewskiego 3, 01-785, Warsaw, Poland.,Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637, Warsaw, Poland
| | - Milko C de Jonge
- Department of Radiology, St. Antonius Hospital Utrecht, Utrecht, The Netherlands
| | - Jean-Luc Drapé
- Service de Radiologie B, Groupe Hospitalier Cochin, AP-HP Centre, Université de Paris, 75014, Paris, France
| | - Marc Mespreuve
- Department of Medical Imaging, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Via G. C. Pupilli 1, 40136, Bologna, Italy
| | - Guillaume Bierry
- MSK Imaging, University Hospital, 1 Avenue Molière, 67098, Strasbourg Cedex, France
| | - Danoob Dalili
- Epsom & St Helier University Hospitals NHS Trust Radiology Department, Dorking Road, Epsom, London, KT18 7EG, UK
| | - Marc Garcia-Elias
- Hand and Upper Extremity Surgery, Creu Blanca, P° Reina Elisenda 57, 08022, Barcelona, Spain
| | - Andrea Atzei
- Pro-Mano, Treviso, Italy and Ospedale Koelliker, Corso G. Ferraris 247, 10134, Torino, Italy
| | - Gregory Ian Bain
- Department of Orthopaedic Surgery, Flinders University, Bedford Park, Adelaide, South Australia, Australia
| | | | - Francisco Del Piñal
- Instituto de Cirugía Plástica y de la Mano, Serrano 58 1B, 28001, Madrid, Spain
| | - Luc Van Overstraeten
- Hand and Foot Surgery Unit (HFSU) SPRL, Rue Pierre Caille 9, 7500, Tournai, Belgium.,Department of Orthopaedics and Traumatology, Erasme University Hospital, Route de Lennik, 808, Brussels, Belgium
| | - Robert M Szabo
- Department of Orthopaedic Surgery, University of California Davis, Health System, 4800 Y Street, Sacramento, CA, 95817, USA
| | - Emmanuel J Camus
- Hand Surgery Unit, Clinique de Lille Sud, 96 Rue Gustave Delory, Lesquin, France
| | | | - Adrian Julian Chojnowski
- Orthopaedics and Trauma Department, Hand and Upper Limb Surgery, Norfolk and Norwich University NHS Trust Hospital, Colney Lane, Norwich, NR4 7UY, UK
| | - Jörg G Grünert
- Department of Hand, Plastic and Reconstructive Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Piotr Czarnecki
- Traumatology, Orthopaedics and Hand Surgery Department, Poznan University of Medical Sciences, ul. 28 Czerwca 1956r. nr 135/147, 61-545, Poznań, Poland
| | - Fernando Corella
- Orthopedic and Trauma Department, Hospital Universitario Infanta Leonor, C/ Gran Vía del Este N° 80, 28031, Madrid, Spain.,Hand Surgery Unit, Hospital Universitario Quirónsalud Madrid, Madrid, Spain.,Surgery Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Ladislav Nagy
- Faculty of Medicine, University of Zurich, Pestalozzistrasse 3, 8091, Zurich, Switzerland.,Division for Hand Surgery and Surgery of Peripheral Nerves, Balgrist University Hospital, University of Zurich, Forchstrasse, 340, 8008, Zurich, Switzerland
| | - Michiro Yamamoto
- Department of Hand Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan
| | - Igor O Golubev
- Hand and Microsurgery Division, National Medical Research Centre of Traumatology and Orthopaedic named after N.N. Priorov, Moscow, Russia
| | - Jörg van Schoonhoven
- Clinic for Hand Surgery, Rhön Medical Center, Campus Bad Neustadt, Von Guttenberg-Straße 11, 97616, Bad Neustadt/Saale, Germany
| | - Florian Goehtz
- Clinic for Hand Surgery, Rhön Medical Center, Campus Bad Neustadt, Von Guttenberg-Straße 11, 97616, Bad Neustadt/Saale, Germany
| | - Maciej Klich
- Department of Traumatology and Orthopaedics, Postgraduate Medical Center, A. Gruca Teaching Hospital, Otwock, Poland
| | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartańska 1, 02-637, Warsaw, Poland
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