Effect of traction on wrist joint space and cartilage visibility with and without MR arthrography

Lee, Ryan K. L.; Griffith, James F.; Tang, Wai Kwong; Ng, Alex Wing Hung; Yeung, D.

doi:10.1259/bjr.20160932

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…Guntern et al recently demonstrated that a 3-kg distraction load on the wrist significantly expands the radiocarpal and midcarpal joints, particularly the radioscaphoid and lunocapitate spaces [ 18 ]. Lee et al reported that traction significantly improves the cartilage surface visibility for standard MRI of the wrist, although the effect was not as obvious as that seen with MR arthrography or MR arthrography with traction [ 17 ]. Orthopedic surgeons have also used axial traction of the wrist for treatment and diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…We suspected that the pain during traction was caused by vascular insufficiency due to the use of the Chinese finger trap. The maximal traction weight in this study (5 kg) is acceptable in a clinical setting because 4.5 kg (10 pounds) of traction is usually applied for fingers when performing wrist or thumb arthroscopy [ 17 , 19 , 25 ]. However, the traction of the thumb in patients with thumb CMC joint arthritis may exacerbate pain and other symptoms, although these symptoms disappear within a short period in healthy volunteers.…”

Section: Discussionmentioning

confidence: 99%

“…The ideal traction weight for the thumb has not been determined to date; therefore, traction weights of 2 and 5 kgs were used based on previous literature [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

“…The other end of the rope was hung over the edge of the MR table via a pulley system and attached to nonmagnetic traction weights (Figure 1). The ideal traction weight for the thumb has not been determined to date; therefore, traction weights of 2 and 5 kgs were used based on previous literature [17].…”

Section: Application Of Axial Traction During Mrimentioning

confidence: 99%

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Effects of Magnetic Resonance Imaging With Axial Traction of the Thumb Carpometacarpal Joint on Articular Cartilage Visibility: A Feasibility Study

Ikumi¹,

Kohyama²,

Okuwaki³

et al. 2022

Cureus

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The objective of this study was to verify the usefulness of magnetic resonance imaging (MRI) with axial traction of the thumb for observing articular cartilage. Materials and methodsEleven healthy adult volunteers (39.7 ± 7.4 years) without thumb carpometacarpal joint arthritis or trauma were included in this study. A 3-tesla (3T) MRI (Magnetom Skyra, Siemens Healthineers AG, Munich, Germany) of the right thumb with axial traction applied by a finger trap with three traction weights (0, 2, and 5 kg) was performed. A 3D T2* multiecho data imaging combination (MEDIC) was selected to visualize the articular cartilage. After multiplanar reconstruction, sagittal and coronal images of the thumb carpometacarpal joint were used to evaluate the articular cartilage visibility and joint space widths at five locations. Articular cartilage visibility was evaluated using our original classification method that used the percentage of the cartilage detectable area. The Friedman test was used to compare the differences between each traction weight and location. ResultsArticular cartilage visibility significantly improved with axial traction. The average joint space widths with the 5-kg application were 1.9 ± 0.8, 3.9 ± 0.6, 2.0 ± 0.9, 3.9 ± 1.1, and 2.5 ± 1.4 mm at the center, volar edge, dorsal edge, radial edge, and ulnar edge, respectively. The joint space widths significantly increased proportionally with the traction weight at all locations. The joint space widths at the volar and radial edges were significantly greater than those at other locations. ConclusionApplying axial traction to the thumb increased the joint space widths and improved the visibility of the articular cartilage in the carpometacarpal joint on MRI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The ideal traction weight for the thumb has not been determined to date; therefore, traction weights of 2 and 5 kgs were used based on previous literature [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Application Of Axial Traction During Mrimentioning

confidence: 99%

See 2 more Smart Citations

Effects of Magnetic Resonance Imaging With Axial Traction of the Thumb Carpometacarpal Joint on Articular Cartilage Visibility: A Feasibility Study

Ikumi¹,

Kohyama²,

Okuwaki³

et al. 2022

Cureus

View full text Add to dashboard Cite

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“…At our center, we use finger traps 34 to suspend a traction weight over the edge of the MR table. Traction is set up outside the MR room so all that is required in the MR room is to clip the traction weight to the fingers, which takes < 5 minutes.…”

Section: Tip 10: Know the Benefits Of Traction Mrimentioning

confidence: 99%

Top-Ten Tips for Imaging the Triangular Fibrocartilaginous Complex

Tong

Hung

et al. 2019

Semin Musculoskelet Radiol

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The triangular fibrocartilage complex (TFCC) is a crucial structure for both maintaining the stability of the distal radioulnar joint (DRUJ) and acting as a cushion for axial loading of the ulnocarpal joint. Injury to the TFCC can lead to early degeneration of the DRUJ and ulnocarpal joint, with resultant chronic wrist pain and weakness. The TFCC is a moderately complex structure with several attachments to the adjacent bony and cartilaginous structures. Familiarity with the anatomy of the TFCC is a prerequisite for identification of TFCC tears. Several pitfalls can occur while assessing the TFCC on magnetic resonance imaging (MRI) if one is not familiar with the MRI appearances. This article illustrates key tips for diagnosing TFCC tears on MRI.

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