The Wrist Insufflation Test: A Confirmatory Test for Detecting Intercarpal Ligament and Triangular Fibrocartilage Complex Tears
Bibliographic record
Abstract
PURPOSE: The purpose of this study was to determine the accuracy of the wrist insufflation test based on mean radiocarpal and midcarpal joint space volumes. METHODS: Twenty-nine patients underwent 3-4 portal radiocarpal and radial midcarpal portal insufflation before wrist arthroscopy. The volume remaining in the radiocarpal space at equilibrium was recorded, and the contour of the dorsal wrist and distal radioulnar joint was palpated for a fluid wave. After insufflation, wrist arthroscopy was performed and diagnoses were recorded. The mean volumes of the intact radiocarpal and midcarpal spaces were then compared with those of the compromised radiocarpal and midcarpal spaces to determine the overall sensitivity and specificity of the test. RESULTS: A total of 29 patients (18 male and 11 female) underwent wrist insufflation before wrist arthroscopy. The mean age of the patients was 42 years (range, 17 to 69 years). Intact radiocarpal spaces accepted a mean of 3.5 ± 0.16 mL of fluid, whereas compromised radiocarpal spaces accepted a mean of 5.5 ± 0.48 mL of fluid (P < .01; 95% confidence interval, 2.87 to 3.30). Intact midcarpal spaces accepted a mean of 2.5 ± 0.18 mL, whereas compromised midcarpal spaces accepted a mean of 5.6 ± 0.38 mL (P < .01; 95% confidence interval, 1.70 to 2.30). The overall sensitivity of the test was 83.3%, and the overall specificity was 100%. CONCLUSIONS: Complete scapholunate interosseous ligament and triangular fibrocartilage complex tears can be detected when there is an increased radiocarpal joint space volume with insufflation through the 3-4 portal combined with a fluid wave over the radial midcarpal space or the distal radioulnar joint. Complete scapholunate interosseous ligament and lunotriquetral interosseous ligament tears can also be detected when there is an increased midcarpal space volume with insufflation through the radial midcarpal portal combined with a fluid wave over the radial radiocarpal space or the ulnar radiocarpal space. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".