“Arthrography of the Wrist. Assessment of the Integrity of the Ligaments in Young Asymptomatic Adults” (77-A: 1207–1209, Aug. 1995), by Kirschenbaum et al., presents interesting information. The authors are to be commended for the concept and design of their study. However, their interpretation of the data needs further discussion; we question whether the important message of this paper was presented clearly.

Depending on the experience and bias of the reader, this article can be interpreted in one of two ways. A superficial interpretation is that, since asymptomatic defects are evident on arthrography, then arthrography has no value; unfortunately, the authors emphasized this interpretation, and, along with the Editorial Board of Reviewers, they missed the more important message of their study. The second interpretation, which is not as obvious to the casual or inexperienced reader, is that asymptomatic defects commonly occur and are revealed by a variety of diagnostic means (including arthrography, magnetic resonance imaging, and arthroscopy) but are clinically relevant only if a good clinical examination reveals a positive correlation. None of these diagnostic methods for showing communicating (or non-communicating) defects can demonstrate which defects are causing pain. Rather, the value of …

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