Dynamic CT Scan of the Normal Scapholunate Joint in a Clenched Fist and Radial and Ulnar Deviation

Kelly, Paul; Hopkins, John G; Furey, Andrew; Squire, Daniel

doi:10.1177/1558944717726372

Cited by 13 publications

(16 citation statements)

References 24 publications

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“…First, we studied a relatively small cohort of 35 wrists in 19 asymptomatic volunteers. However, this cohort size is in line with prior literature evaluating clinical [5,8,[40][41][42], biomechanical [6,[43][44][45], and dynamic CT [21][22][23][46][47][48][49] aspects of wrist disorders. Although our analysis serves as a foundation for future work on normal and abnormal kinematic patterns, we did not analyze symptomatic patients or have clinical justification to correlate findings with radiography, fluoroscopy, CT, or histopathology in our asymptomatic volunteers.…”

Section: Discussionsupporting

confidence: 80%

Dynamic MRI of the wrist in less than 20 seconds: normal midcarpal motion and reader reliability

et al. 2019

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OBJECTIVE-To describe the normal motion pattern at the midcarpal compartment during active radial-ulnar deviation of the wrist using dynamic MRI and to determine the observer performance for measurements obtained in asymptomatic volunteers.METHODS-Dynamic MRI of 35 wrists in 19 asymptomatic volunteers (age mean 30.4 yrs, sd 8.6) was performed during active radial-ulnar deviation using a fast gradient-echo pulse sequence with 315 ms temporal resolution (acquisition time, 19 sec). Two independent readers measured the transverse translation of the trapezium at the scaphotrapezium joint (STJ) and the capitate-to-Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. http://www.springer.com/gb/openaccess/authors-rights/aam-terms-v1

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Section: Discussionsupporting

confidence: 80%

Dynamic MRI of the wrist in less than 20 seconds: normal midcarpal motion and reader reliability

et al. 2019

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“…The flexion of the scaphoid in a SL injury had been documented and is known to be the beginning of degenerative arthritis, such as scapholunate advanced collapse (SLAC) [4,22]. While the progression of such a disease in relation to bone position is well documented, it is unclear what the relationship is between laxity, dynamic carpal motion, and the onset and progression of carpal instabilities [10].…”

Section: Discussionmentioning

confidence: 99%

“…Mat Jais et al used 4DCT with cadavers which had undergone different ligament injury simulations and found the magnitude of translation relative to the neutral position in the x-, y-, and z-axes to be, on average, 0.01-1.24 mm; while translation increased with successive injury simulations, it was not drastically different than the intact state [4]. Kelly et al measured the gap between the scaphoid and lunate in cadaveric wrists during RUD and found there to be very small gaps (<1.20 mm), indicative of minimal scapholunate separation in normal wrists [22]. Demehri et al measured the scapholunate interval in vivo in healthy wrists and calculated the interval to be < 1 mm in RUD [23].…”

Section: Discussionmentioning

confidence: 99%

“…A limitation in the literature is the lack of characterization surrounding the dose from 4DCT. Table 1 summarizes dose values for other studies of similar nature; there is inconsistency in which values are reported (DLP, effective dose, and/or total skin dose) and for how many scans they are reported (one scan or motion pass, or the total CT scanning protocol) [1,5,6,22,25,[30][31][32][33]. Furthermore, DLP depends on the duration of X-ray exposure(s), the amount of radiation produced per rotation (mAs), and the range of the scan (mm).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Four-Dimensional Computed Tomography as a Technique for Quantifying Carpal Motion

Robinson

Straatman

Lee

et al. 2021

Journal of Biomechanical Engineering

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Delayed diagnosis of dynamic carpal instability often occurs because early changes in bone alignment and movement are difficult to detect and manifest mainly during a dynamic/functional task. Current diagnostic tools are only able to examine the carpal bones under static or sequential-static conditions. Four-dimensional (three dimensions + time) computed tomography (4DCT) enables quantification of carpal mechanics through 3D volume sequences of the wrist in motion. A comprehensive understanding of carpal mechanics is needed to define normal function and structure and provide targets for treatment of carpal injuries. In this study, measurements of scaphoid translation and joint congruency were taken by creating models from the CT scans of the carpals in extreme frames of motion, registering those models to the neutral position, transforming the models into a local coordinate system, and using software to calculate the joint surface areas (JSA). Results indicated that the centroid of the scaphoid translated 6.4 ± 1.3 mm and extended from extreme radial to extreme ulnar deviation. Results are consistent with the literature. An additional study was performed to measure the responsiveness of the 4DCT technique presented. Bone models from each frame of motion for radioulnar deviation (RUD) and flexion extension (FE) were created and distinct differences between their JSA were measured qualitatively and quantitatively. The results show that there was statistically significantly different JSA within carpal joints between RUD and FE. These studies provide the first step in developing the methodology when using 4DCT scanning to measure subtle abnormalities in the wrist.

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“…Recently, dynamic MRI of the wrist was used to assess carpal instability and evaluate the integrity of the intrinsic ligaments 24–26 . In the past, such studies have been performed using plain radiographs such as the clenched fist view where the patient grips a pencil (“pencil grip view”), stressing the scapholunate ligament to evaluate for widening, 27 with a role suggested for 4D CT 28,29 . Contemporary fast MRI techniques can acquire similar kinematic data while avoiding exposure to ionizing radiation.…”

Section: Introductionmentioning

confidence: 99%

Twenty‐four–channel high‐impedance glove array for hand and wrist MRI at 3T

Zhang

Wang

et al. 2021

Magnetic Resonance in Med

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To present a novel 3T 24-channel glove array that enables hand and wrist imaging in varying postures. Methods:The glove array consists of an inner glove holding the electronics and an outer glove protecting the components. The inner glove consists of four main structures: palm, fingers, wrist, and a flap that rolls over on top. Each structure was constructed out of three layers: a layer of electrostatic discharge flameresistant fabric, a layer of scuba neoprene, and a layer of mesh fabric. Lightweight and flexible high impedance coil (HIC) elements were inserted into dedicated tubes sewn into the fabric. Coil elements were deliberately shortened to minimize the matching interface. Siemens Tim 4G technology was used to connect all 24 HIC elements to the scanner with only one plug. Results:The 24-channel glove array allows large motion of both wrist and hand while maintaining the SNR needed for high-resolution imaging. Conclusion:In this work, a purpose-built 3T glove array that embeds 24 HIC elements is demonstrated for both hand and wrist imaging. The 24-channel glove array allows a great range of motion of both the wrist and hand while maintaining a high SNR and providing good theoretical acceleration performance, thus enabling hand and wrist imaging at different postures to extract kinematic information.

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Dynamic CT Scan of the Normal Scapholunate Joint in a Clenched Fist and Radial and Ulnar Deviation

Abstract: This novel dynamic CT scan of the wrist is a user-friendly way of measuring of the scapholunate distance, which is minimal in the normal wrist below 40 years of age.

Cited by 13 publications

References 24 publications

Dynamic MRI of the wrist in less than 20 seconds: normal midcarpal motion and reader reliability

Dynamic MRI of the wrist in less than 20 seconds: normal midcarpal motion and reader reliability

Evaluation of Four-Dimensional Computed Tomography as a Technique for Quantifying Carpal Motion

Twenty‐four–channel high‐impedance glove array for hand and wrist MRI at 3T

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