Motion between

carpal bones (shear and diastasis) was noted and documented. The results for each ligament were recorded as negative (intact) or positive (not intact). A positive CH5424802 chemical structure ligament injury was diagnosed by direct visualisation of the tear with or without 2 mm of shear or diastasis ( Chow, 2005, Geissler, 2005). This may have included a within-substance tear. In addition, laxity was noted. The location of a TFCC tear was also recorded as either peripheral (indicative of a DRUJ ligament injury) or central (indicative of an articular disc injury). Associated intra-articular pathologies, including synovitis, chondromalacia, and ganglia were documented. Likelihood ratios were calculated for diagnostic prediction of provocative tests and MRI, using 3-Methyladenine in vitro arthroscopy as the reference standard for both. Logistic regression was used to evaluate if MRI improved diagnostic accuracy compared to the provocative tests alone. For MRI, the number needed to scan (NNS) in order to make one additional correct diagnosis was also calculated. Of 143 patients screened for inclusion in the study, 105 were eligible to participate. Three declined and 35 did not have an arthroscopy. These patients believed that arthroscopy was not warranted because they were improving. The remaining 105 patients all consented to participate and went on to have arthroscopy. All participants

underwent clinical examination prior to arthroscopy. Fifty-five of the 105 participants also underwent MRI investigation prior to arthroscopy. GRIT measures were missing on two participants but the during dataset was otherwise complete. Ninety-two (87%) of the 105 participants were right-handed, seven were left-handed, and five were ambidextrous. The

mean age of participants was 37 years (SD 12). The median (IQR) time from injury to assessment was 9.6 months (3.9 to 14.8). Sixty-two (59%) of the participants’ work and activities of daily living necessitated a ‘heavy’ demand on the wrist, 39 (37%) a ‘moderate’ demand, and four (4%) a ‘light’ demand (as defined by the 3-point scale of functional demand on the wrist). Fifty-eight participants (55%) reported symptoms in the right wrist. Wrist pain was located in the radial region in 15 (14%), in the ulnar region in 56 (53%), in the central region in 30 (29%), and in all regions in four (4%). Forty-seven participants (44%) reported a sensation of giving way in the wrist on the 4-point participant-perceived stability scale. The giving way was reported in approximately equal proportions across heavy, moderate, and light activity. On the Patient-Rated Wrist and Hand Evaluation questionnaire, the mean pain score was 28 out of 50 (SD 10), the mean function score was 21 out of 50 (SD 10), and the mean total score of pain and function combined was 49 out of 100 (SD 19). Table 1 cross-tabulates the provocative test and arthroscopic findings.