Lack of correlation between site of wrist pain and location of noncommunicating defects shown by three-compartment wrist arthrography

Communicating defects shown by wrist arthrography often correlate poorly with the location of the patient's symptom(s). No study of wrist arthrography in which noncommunicating defects have been isolated, described, and correlated with the site of patients' symptoms has been reported. The aim of this study was to correlate the site(s) of patients' pain and the location(s) of noncommunicating defects shown by wrist arthrography. One hundred noncommunicating capsular defects and incomplete defects of the interosseous ligaments and triangular fibrocartilage in 82 patients were identified from 462 three-compartment wrist arthrograms. Correlation between the sites of pain and sites of the noncommunicating defect was described as: (1) exact correlation, (2) ulnar/radial side correlation, (3) ambiguous correlation, or (4) no correlation. Statistical analysis was performed for each type of defect separately, in aggregate for patients who had more than one defect, and by separate analysis using patients' age (less than or greater than 30 years old). Capsular defects were detected in 65 patients, incomplete perforations of the triangular fibrocartilage in 28 patients, and incomplete defects of the scapholunate and lunotriquetral ligament in three patients each. No statistically significant correlation was found between individual defects and symptoms or between the site(s) of symptoms and patterns of multiple noncommunicating defects. Further, age did not influence the degree of correlations (chi 2 = 0.000-0.476, p values = 0.49-1.00). Attribution of patient's symptoms to noncommunicating defects shown by wrist arthrography is not reliable. Cases in which site-specific arthrographic defects directly correlate may be fortuitous. Additional studies will be necessary to determine the future role of wrist arthrography in the evaluation of the painful wrist.