Imaging appearance of post-arthroscopic radiocarpal chondrolysis: comparison with osteoarthritis associated with scapholunate dissociation

Euddeum Shim, Baek Hyun Kim, In Young Choi, Suk Joo Hong, Chang Ho Kang, Kyung Sik Ahn

Research output: Contribution to journalArticle

Abstract

Background: Since the diagnosis of post-arthroscopic chondrolysis is very difficult, it can be underdiagnosed and confused with other diseases in clinical practice. Purpose: To propose imaging features of post-arthroscopic radiocarpal chondrolysis (PRCC) and to compare these with osteoarthritis associated with scapholunate dissociation which are the most common misdiagnoses of PRCC. Material and Methods: To identify missed diagnoses of PRCC, 994 magnetic resonance imaging scans performed in 910 patients were retrospectively reviewed. After the identification of 73 patients who exhibited significant radiocarpal cartilage loss, 11 were diagnosed with PRCC. Since scapholunate advanced collapse was the most common incorrect diagnosis of PRCC (4/11), the imaging findings were compared among the 11 patients with PRCC and 14 patients with osteoarthritis caused by scapholunate dissociation who were diagnosed in the same period. The following imaging features were evaluated: scapholunate dissociation; the center of disease and grade of radiocarpal joint destruction; characteristics of bone marrow edema; the presence of radial styloid and distal scaphoid osteophytes; and the extent of joint effusion and synovitis. Results: The imaging diagnosis of PRCC was significantly differentiated from osteoarthritis associated with scapholunate dissociation based on occurrence at a younger age, bone marrow edema crossing the joint, center of disease in the proximal radioscaphoid joint, and absence of radial styloid and scaphoid osteophytes (P < 0.05). PRCC occasionally presented with arch-shape bone marrow edema based on the proximal carpal row. Conclusion: The diagnosis of PRCC can be aided if its characteristic imaging findings are differentiated from other disease entities in patients with a history of arthroscopy.

Original languageEnglish
JournalActa Radiologica
DOIs
Publication statusAccepted/In press - 2020 Jan 1

Keywords

  • arthroscopy
  • chondrolysis
  • magnetic resonance imaging
  • misdiagnosis
  • Radiocarpal joint
  • radiography
  • scapholunate advanced collapse

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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