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Scapholunate Ligament Injury
Julia R. Crim, MD; Sarah Stilwill, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Scapholunate (SL) ligament
              • Between scaphoid and lunate, composed of dorsal and volar bands, thin central membrane
              • Along with lunatotriquetral (LT) ligament, creates water-tight separation between radiocarpal and midcarpal joint
            • Dorsal intercalated segment instability (DISI): Instability pattern related to SL tear, resulting in palmar tilt of scaphoid and dorsal tilt of lunate
              • Extrinsic ligament tears typically also present
            • Scapholunate advanced collapse (SLAC): Chronic instability leads to proximal migration of capitate between scaphoid and lunate, osteoarthritis

          IMAGING

          • General Features

            • Radiographic Findings

              • Imaging Recommendations

                • MR Findings

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            Selected References

                            1. Asaad AM et al: Diagnostic accuracy of single-compartment magnetic resonance arthrography in detecting common causes of chronic wrist pain. J Hand Surg Eur Vol. 1753193417695180, 2017
                            2. Oh E et al: Diagnostic performance of wrist magnetic resonance (MR) arthrography: comparison of three-dimensional isotropic T1 weighted fast spin-echo MR arthrography and two-dimensional MR arthrography. Br J Radiol. 90(1071):20160867, 2017
                            3. Hafezi-Nejad N et al: Scapholunate interosseous ligament tears: diagnostic performance of 1.5T, 3T MRI, and MR arthrography-a systematic review and meta-analysis. Acad Radiol. 23(9):1091-103, 2016
                            4. Binder AC et al: Dorsal wrist capsular tears in association with scapholunate instability: results of an arthroscopic dorsal capsuloplasty. J Wrist Surg. 2(2):160-7, 2013
                            5. Manuel J et al: The diagnosis and treatment of scapholunate instability. Orthop Clin North Am. 38(2):261-77, vii, 2007
                            6. Robinson G et al: Axial oblique MR imaging of the intrinsic ligaments of the wrist: initial experience. Skeletal Radiol. 35(10):765-73, 2006
                            7. Cerezal L et al: Wrist MR arthrography: how, why, when. Radiol Clin North Am. 43(4):709-31, viii, 2005
                            8. Schmid MR et al: Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging. Radiology. 237(3):1008-13, 2005
                            9. Haims AH et al: Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging. Radiology. 227(3):701-7, 2003
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Pathology

                                  • Clinical Issues

                                    TERMINOLOGY

                                    • Definitions

                                      • Scapholunate (SL) ligament
                                        • Between scaphoid and lunate, composed of dorsal and volar bands, thin central membrane
                                        • Along with lunatotriquetral (LT) ligament, creates water-tight separation between radiocarpal and midcarpal joint
                                      • Dorsal intercalated segment instability (DISI): Instability pattern related to SL tear, resulting in palmar tilt of scaphoid and dorsal tilt of lunate
                                        • Extrinsic ligament tears typically also present
                                      • Scapholunate advanced collapse (SLAC): Chronic instability leads to proximal migration of capitate between scaphoid and lunate, osteoarthritis

                                    IMAGING

                                    • General Features

                                      • Radiographic Findings

                                        • Imaging Recommendations

                                          • MR Findings

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    • Treatment

                                                      Selected References

                                                      1. Asaad AM et al: Diagnostic accuracy of single-compartment magnetic resonance arthrography in detecting common causes of chronic wrist pain. J Hand Surg Eur Vol. 1753193417695180, 2017
                                                      2. Oh E et al: Diagnostic performance of wrist magnetic resonance (MR) arthrography: comparison of three-dimensional isotropic T1 weighted fast spin-echo MR arthrography and two-dimensional MR arthrography. Br J Radiol. 90(1071):20160867, 2017
                                                      3. Hafezi-Nejad N et al: Scapholunate interosseous ligament tears: diagnostic performance of 1.5T, 3T MRI, and MR arthrography-a systematic review and meta-analysis. Acad Radiol. 23(9):1091-103, 2016
                                                      4. Binder AC et al: Dorsal wrist capsular tears in association with scapholunate instability: results of an arthroscopic dorsal capsuloplasty. J Wrist Surg. 2(2):160-7, 2013
                                                      5. Manuel J et al: The diagnosis and treatment of scapholunate instability. Orthop Clin North Am. 38(2):261-77, vii, 2007
                                                      6. Robinson G et al: Axial oblique MR imaging of the intrinsic ligaments of the wrist: initial experience. Skeletal Radiol. 35(10):765-73, 2006
                                                      7. Cerezal L et al: Wrist MR arthrography: how, why, when. Radiol Clin North Am. 43(4):709-31, viii, 2005
                                                      8. Schmid MR et al: Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging. Radiology. 237(3):1008-13, 2005
                                                      9. Haims AH et al: Internal derangement of the wrist: indirect MR arthrography versus unenhanced MR imaging. Radiology. 227(3):701-7, 2003