Anatomical Wrist Patterns on Plain Radiographs

Author(s): Aviv Kramer, Raviv Allon, Alon Wolf, Tal Kalimian, Idit Lavi, Ronit Wollstein*

Journal Name: Current Rheumatology Reviews

Volume 15 , Issue 2 , 2019

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Graphical Abstract:


Background: Interpreting the structure in the wrist is complicated by the existence of multiple joints as well as variability in bone shapes and anatomical patterns. Previous studies have evaluated lunate and capitate shape in an attempt to understand functional anatomical patterns.

Objective: The purpose of this study was to describe anatomical shapes and wrist patterns in normal wrist radiographs. We hypothesized that there is a significant relationship in the midcarpal joint with at least one consistent pattern of wrist anatomy.

Methods: Seventy plain posteroanterior (PA) and lateral wrist radiographs were evaluated. These radiographs were part of a previously established normal database, had all been read by a radiologist as normal, and had undergone further examination by 2 hand surgeons for quality. Evaluation included: lunate and capitate shape (type 1 and 2 lunate shape according to the classification system by Viegas et al.), ulnar variance, radial inclination and height, and volar tilt.

Results: A significant association was found between lunate and capitate shape using a dichotomal classification system for both lunate and capitate shapes (p=0.003). Type 1 wrists were defined as lunate type1and a spherical distal capitate. Type 2 wrists had a lunate type 2 and a flat distal capitate. No statistically significant associations were detected between these wrist types and measurements of the radiocarpal joint.

Conclusion: There was a significant relationship between the bone shapes within the midcarpal joint. These were not related to radiocarpal anatomical shape. Further study is necessary to better describe the two types of wrist patterns that were defined and to understand their influence on wrist biomechanics and pathology.

Keywords: Midcarpal joint, morphology, patterns, radiographs, wrist, radiographs.

Sharma GB, McMahon PJ, Robertson DD. Structure modeling of the glenoid: Relevance to shoulder arthroplasty. J Orthop Res 2014; 32(11): 1471-8.
Crisco JJ, Heard WM, Rich RR, Paller DJ, Wolfe SW. The mechanical axes of the wrist are oriented obliquely to the anatomical axes. J Bone Joint Surg Am 2011; 93(2): 169-77.
Pellegrini VD Jr. Comparative pathoanatomy of the Asian and Caucasian trapeziometacarpal joint. Ann Acad Med Singapore 1995; 24(4)(Suppl.): 21-5.
Xiao L, Li YK, Ye GH, Yang XW. Variations in the extensor grooves on the radial styloid process in Chinese population. Surg Radiol Anat 2013; 35(1): 49-53.
Wang YC, Tseng YC, Chang HY, Wang YJ, Chen CJ, Wu DY. Gender differences in carpal height ratio in a taiwanese population. J Hand Surg Am 2010; 35(2): 252-5.
McLean JM, Turner PC, Bain GI, Rezaian N, Field J, Fogg Q. An association between lunate morphology and scaphoid-trapezium-trapezoid arthritis. J Hand Surg Eur Vol 2009; 34(6): 778-82.
Haase SC, Berger RA, Shin AY. Association between lunate morphology and carpal collapse patterns in scaphoid nonunions. J Hand Surg Am 2007; 32(7): 1009-12.
Viegas SF. The lunatohamate articulation of the midcarpal joint. Arthroscopy 1990; 6(1): 5-10.
Viegas SF. Variations in the skeletal morphologic features of the wrist. Clin Orthop Relat Res 2001; (383): 21-31.
Hardy DC, Totty WG, Reinus WR, Gilula LA. Posteroanterior wrist radiography: Importance of arm positioning. J Hand Surg Am 1987; 12(4): 504-8.
Koh KH, Lee HI, Lim KS, Seo JS, Park MJ. Effect of wrist position on the measurement of carpal indices on the lateral radiograph. J Hand Surg Eur Vol 2013; 38(5): 530-41.
Wollstein R, Werner FW, Rubenstein R, Nacca CR, Bilonick RA, Gilula LA. Scaphoid translation measurements in normal wrists. Hand Surg 2013; 18(2): 179-87.
O’Malley MP, Rodner C, Ritting A, et al. Radiographic interpretation of distal radius fractures: visual estimations versus digital measuring techniques. Hand (N Y) 2014; 9(4): 488-93.
Yazaki N, Burns ST, Morris RP, Andersen CR, Patterson RM, Viegas SF. Variations of capitate morphology in the wrist. J Hand Surg Am 2008; 33(5): 660-6.
Niacaris T, Ming BW, Lichtman DM. Midcarpal instability: A comprehensive review and update. Hand Clin 2015; 31(3): 487-93.
Mohammed Ali MH. A normal data-base of posteroanterior radiographic measurements of the wrist in healthy Egyptians. Surg Radiol Anat 2009; 31(9): 665-74.

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Article Details

Year: 2019
Published on: 04 April, 2019
Page: [168 - 171]
Pages: 4
DOI: 10.2174/1573397113666170417124711
Price: $65

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