Effects of Axial Traction during Direct MR-Arthrography of the Wrist in Sports Injuries

Purpose: To evaluate the degree of joint distraction during direct MR arthrography with axial traction in sports injuries. To confirm the effect of axial traction on the quality of wrist opacification. Patients and methods: Seventeen patients (11 male, 6 female) underwent wrist MR arthrography without (mean: 39 years (SD 11.6))., and 20 patients (16 male, 4 female) with axial traction (mean: 28 years (SD 7.1)). Subgroups were defined according to pathology: degenerative, ligamentous, traumatic, normal (ie patients without MR-arthrography lesions). Radioscaphoid, radiolunate, lunocapitate, ulna Triangular Fibrocartilage (TFC), scapho-lunate, luno-triquetral, ulnocarpal, Carpo-Metacarpal (CMC) I and III and distal radio-ulnar spaces were measured for all patients. Differences in joint space width were compared between subgroups. Joint space opacification was subjectively scored from 0 (no opacification) to 3 (fully opacified), and compared between the groups with and without traction. Results: The difference in joint space was statistically significant ( p <0.05) for radioscaphoid, radiolunate, lunocapitate and ulnocarpal spaces, but only in patients with ligamentous tears. Opacification score was significantly higher for ulnocarpal ( p =0.0275) and CMC III joint spaces ( p =0.0272) with axial traction. Conclusion: Axial traction resulted in a significantly higher radioscaphoid, radio-lunate, lunocapitate and ulnocarpal joint spaces width. This positive effect of axial traction raises the suspicion of sports ligamentous lesions.