Evaluation of ulnar variance on wrist MR imaging: is it a reliable measure?

Serfaty, Aline; Costa, Hugo Pereira; Foelker, Conrado Eduardo; Filho, Eduardo Noda Kihara; Souza, Felipe Ferreira de; Bordalo-Rodrigues, Marcelo

doi:10.1007/s00256-019-03339-1

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…Previously, these values were found as good to excellent in various studies using radiographs for both inter- and intra-observer reliabilities, with an intraclass coefficient range of 0.82–0.93 for inter-observer and an intraclass correlation coefficient (ICC) of 0.931 for intra-observer reliability (4,41–44). In a study conducted using MRI, ICCs for inter- and intra-observer reliability were 0.857 and 0.915, respectively (4). In another study involving pediatric population, ICC values were 0.88–0.92 for intra-observer reliability and 0.75 for inter-observer reliability (5,45).…”

Section: Discussionmentioning

confidence: 90%

“…Our inter-and intra-observer agreement values for UV measurement on coronal CT slices using the perpendicularis technique were excellent. Previously, these values were found as good to excellent in various studies using radiographs for both inter-and intra-observer reliabilities, with an intraclass coefficient range of 0.82-0.93 for inter-observer and an intraclass correlation coefficient (ICC) of 0.931 for intra-observer reliability (4,(41)(42)(43)(44). In a study conducted using MRI, ICCs for inter-and intra-observer reliability were 0.857 and 0.915, respectively (4).…”

Section: Discussionmentioning

confidence: 91%

“…Both CT and MRI of the wrist are usually performed in the prone position with the arm extended above the head and do not match the position previously defined. Although radiographs are accepted as the gold standard for UV evaluation, Serfaty et al and Laino et al have demonstrated MRI to be a reliable method in this regard (4,40). Coronal reconstructed CT images are also similar to coronal MR images and were used in the evaluation of UV in our study with excellent inter- and intra-observer reliability values.…”

Section: Discussionmentioning

confidence: 99%

“…The term ulnar variance (UV) refers to the relative length difference of the distal articular surfaces of the radius and ulna. UV can be neutral (both surfaces at the same level), positive (ulnar surface more distal), or negative (ulnar surface more proximal), depending on the relative positioning of both joint surfaces (2)(3)(4). UV has been associated with prognosis of distal forearm fractures, Kienböck's disease, ulnar impaction syndrome, triangular fibrocartilage complex degeneration, and carpal instability (2,5).…”

Section: Introductionmentioning

confidence: 99%

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The effect of ulnar variance on the pisotriquetral joint

et al. 2022

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Background Pisotriquetral joint (PTJ) disorders are an important cause of ulnar-sided wrist pain but are often underrecognized. Ulnar variance (UV) has been associated with several wrist pathologies. Purpose To determine the effect of UV on PTJ in patients with trauma. Material and Methods A total of 143 patients (77 men, 66 women; mean age=41.64 ± 18.07 years) were included. Patients with fractures, severe and high-energy trauma, arthritic conditions, avascular necrosis, congenital deformity, bone and soft-tissue tumors, suboptimal image quality, and incorrect joint position were excluded. UV and the amount of PTJ subluxation were evaluated using coronal and sagittal computed tomography images. Results PTJ subluxation was divided into five grades. A statistically significant difference was found between the presence of PTJ subluxation and sex ( P = 0.045). PTJ subluxation was more common in men (46.8%) than in women (30.3%). There was no significant difference between the presence of PTJ subluxation and age ( P = 0.758). The patients were also divided into three groups as positive, neutral, and negative UV. A statistically significant relationship was found between the UV and presence of PTJ subluxation ( P = 0.01). PTJ subluxation was significantly less in the neutral (none=51.1%, present=48.9%; P < 0.05) and negative (none=77.8%, present=22.2%; P < 0.05) groups. Conclusion PTJ subluxation was found to be less among the groups with neutral and negative UV in our study population. PTJ subluxation is more common in men while there is no relationship with age. UV and gender may be risk factors for PTJ subluxation by affecting force dynamics at the wrist joint.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effect of ulnar variance on the pisotriquetral joint

et al. 2022

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“…In the coronal view of the PD-FS sequence, three consecutive slices were selected in which the whole TFCC, including the radial and ulnar insertion, could be visualized best. According to Yoshioka’s method, the disc thickness and ulnar variance were measured in these slices, and the mean value was calculated (Serfaty et al., 2020; Yoshioka et al., 2007). When there was a complete and large perforation, the disc thickness was not measurable and was recorded as zero.…”

Section: Methodsmentioning

confidence: 99%

Abnormal MRI signal intensity of the triangular fibrocartilage complex in asymptomatic wrists

Wang

Chen

Liu

et al. 2022

J Hand Surg Eur Vol

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We investigated abnormal MRI findings of the triangular fibrocartilage complex in 154 asymptomatic volunteers (21–79 years). Except prevalence, we focused on the morphological features of abnormal signals in relation to age. The majority of full-thickness tears were located in the articular disc (63 participants). The incidence of disc perforation with characteristics of ulnar impaction syndrome increased significantly with age. Asymptomatic full-thickness tears of the ulnar attachment were found in ten participants (seven over 60 years old). The proximal and distal laminae of the ulnar attachment could not be differentiated in 36 participants. In conclusion, MRI is of limited value for the elderly in diagnosing triangular fibrocartilage disorders. For young subjects, MRI is still valuable, especially in diagnosing ulnar detachment, although the ability to distinguish between proximal and distal laminae remains questionable. Disc perforations in volunteers mimicked ulnar impaction syndrome, therefore age, clinical signs and other factors should also be considered in clinical diagnosis. Level of evidence: III

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