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MRI assessment recommended for carpal arthritis patients

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MRI is more accurate than X-ray when evaluating patients with carpal osteoarthritis, new research suggests.

The findings of the study could change the surgical management of degenerative carpal arthritis patterns in the wrist, such as Scapholunate Advanced Collapse (SLAC) and Scaphoid Nonunion Advanced Collapse (SNAC), which can result from traumatic carpal bone fractures.

Radiographic methods have historically been used to determine SLAC progression, but these are not always sensitive. Researchers from Hospital for Special Surgery assessed the prevalence of radiolunate (RL) ligament wear in SLAC/SNAC patients according to operative findings and compared the diagnostic accuracy of MRI and radiographs.

The retrospective study looked at 41 patients who underwent wrist surgery between 2006 and 2016 and were diagnosed with SLAC or SNAC with preoperative imaging.

Operative and MRI findings showed that RL wear occurs in late SLAC/SNAC patients. The researchers determined that plain radiograph findings underestimate the degree of involvement and that MRI has a potentially higher diagnostic accuracy for detection of RL wear. MRI findings had a stronger correlation with operative pathologic findings than radiograph, they said.

The results of the study suggest that surgeons should consider taking a high-resolution MRI prior to joint preserving surgery in the wrist.

The findings were presented at the recent annual meeting of the American Association for Hand Surgery.