wrist instability, SL ligament
Conditions
Interventions
Patients will be recruited following referral from a secondary care physician and consented to have an additional diagnostic test, namely a 4D CT scan and questionnaires, concerning wrist function. A
bilateral 4D CT scan of the SLI wrist will be performed. 
Within two to three weeks of recruitment, the 4D CT scans will be acquired. To investigate patient reported outcomes, four questionnaires will send to the patient after the 4D CT scan via email. All t
Within two to three weeks after CT scanning, the patients will undergo arthroscopy of the symptomatic wrist (normal diagnostic procedure). After this arthroscopy the patient will receive one questionn
Three months after the inclusion the patient will receive three questionnaires by mail. 
Twelve months after treatment three questionnaires will be filled in by both surgically and non-surgically treated patients. Moreover, the patients who received surgery will undergo another 4D CT scan
Sponsors
Radboud Universitair Medisch Centrum
Eligibility
Age
16 Years to 64 Years
Inclusion criteria
Inclusion criteria: Between 16 – 60 years Suspicion of SLIL injuryClinical indication for arthroscopy Clear understanding of the Dutch language Range of motion (ROM) radial/ulnar deviation = 30 degrees left and right wristROM flexion = 25 degrees, extension = 30 degrees left and right wrist
Exclusion criteria
Exclusion criteria: Radial- or midcarpal arthritis visible on plain radiographNot able to undergo an arthroscopy Medical history of wrist trauma and/or wrist surgery that could affect wrist kinematics Bilateral wrist complaints Inflammatory arthritis (rheumatoid) Pregnancy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary endpoint of this study is the diagnostic performance of 4D CT in detecting SL injuries, using arthroscopy as the reference standard. This includes the following diagnostic accuracy measures:Sensitivity (continuous)Specificity (continuous)Accuracy (continuous)Area under the ROC curve (AUC) (continuous)These metrics will be calculated by comparing the classification of SL ligament status (intact, partial lesion, complete lesion) as determined by two radiologists (4D CT) and three hand surgeons (arthroscopy), as described in Section 6.3. Each lesion type will be analyzed in a binary fashion (e.g., complete lesion vs. all others) to allow valid estimation of diagnostic metrics. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary endpoints include:Observer agreement in the interpretation of arthroscopy videos:Intra-observer agreement (Cohen’s kappa)Inter-observer agreement (Fleiss’ kappa)Patient-reported outcomes (e.g., pain, function) and kinematic parameters at 12 months, in relation to:The treatment decision made through shared decision-makingThe findings of 4D CT and arthroscopyThese outcomes may include continuous variables (e.g., range of motion, PROM scores) and will be analyzed accordingly. | — |
Countries
Netherlands
Contacts
Public ContactHS Vries
Radboud Universitair Medisch Centrum
Outcome results
None listed