Quantification of error in measurement of radial inclination angle and radial-carpal distance

DiBenedetto, Michael; Lubbers, Lawrence M.; Ruff, Michael E.; Nappi, James F.; Coleman, Carl R.

doi:10.1016/0363-5023(91)90004-u

Cited by 37 publications

(19 citation statements)

References 8 publications

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“…Observer variability in measurement of distal radius angles has been addressed in two previous studies [1,2]. Friberg and Lundstrom [2] measured radial angle and palmar tilt on 60 normal radiographs.…”

Section: Discussionmentioning

confidence: 98%

“…The effect of forearm rotation on distal radius angle measurements has been investigated in two previous studies [1,3]. Friberg and Lundstrom [3] obtained conventional lateral and 15 ~ lateral radiographs at 5 ~ rotational increments from 10 ~ pronation to 10 ~ supination in 40 wrists with distal radius fractures.…”

Section: Discussionmentioning

confidence: 99%

“…DiBenedetto et al [1] rotated a phantom forearm (skeleton embedded in a plastic matrix used to teach radiographic technique) and obtained posteroanterior radiographs. Such rotation does not accurately replicate forearm pronation and supination, where the forearm does not rotate as a unit but rather the radius rotates about the ulna.…”

Section: Discussionmentioning

confidence: 99%

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Angle measurements of the distal radius: a cadaver study

Johnson

Szabo

1993

Skeletal Radiol.

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The quality of reduction of distal radius fractures is assessed mainly by degree of restoration of radial angle and palmar tilt. This cadaver study investigates the effects of forearm rotation of these measurements. A 5 degree rotational change produces a 1.6 degree change in palmar tilt on the conventional lateral view and a 1.0 degree change on the 15 degree lateral view. Lateral radiographs could be rotated 15 degrees-30 degrees and still be considered acceptable. Therefore, rotation may produce up to a 4.0 degree (15 degrees lateral view) or 6.4 degree (conventional lateral view) change in measured palmar tilt. To provide clearer measuring landmarks and minimize error due to rotation, we recommend obtaining the 15 degree lateral view routinely in fractures with significant dorsal angulation. We also studied the interobserver variability of different surgeons assessing radial angle and palmar tilt. The mean standard deviation between surgeons was 3.2 degrees for radial angle, 3.6 degrees for conventional lateral palmar tilt, and 2.1 degrees for 15 degrees lateral palmar tilt.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Angle measurements of the distal radius: a cadaver study

Johnson

Szabo

1993

Skeletal Radiol.

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“…The antebrachial glenoid is formed by the articular surfaces of the radius and the triangular fibrocartilage complex (TFCC). The radial articular surface, which carries the triangular scaphoid fossa and the rectangular lunate fossa, is tilted ulnarly in about 23 degrees (range 15-35 degrees) and volarly in about 11 degrees (range 0-20 degrees) [9].…”

Section: Distal Forearmmentioning

confidence: 99%

Carpal instability

et al. 2006

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This review addresses the pathoanatomical basics as well as the clinical and radiological presentation of instability patterns of the wrist. Carpal instability mostly follows an injury; however, other diseases, like CPPD arthropathy, can be associated. Instability occurs either if the carpus is unable to sustain physiologic loads ("dyskinetics") or suffers from abnormal motion of its bones during movement ("dyskinematics"). In the classification of carpal instability, dissociative subcategories (located within proximal carpal row) are differentiated from non-dissociative subcategories (present between the carpal rows) and combined patterns. It is essential to note that the unstable wrist initially does not cause relevant signs in standard radiograms, therefore being "occult" for the radiologic assessment. This paper emphasizes the high utility of kinematographic studies, contrast-enhanced magnetic resonance imaging (MRI) and MR arthrography for detecting these predynamic and dynamic instability stages. Later in the natural history of carpal instability, static malalignment of the wrist and osteoarthritis will develop, both being associated with significant morbidity and disability. To prevent individual and socio-economic implications, the hand surgeon or orthopedist, as well as the radiologist, is challenged for early and precise diagnosis.

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“…We measured radial inclination, volar tilt, and radial height and compared those measurements with accepted normal values. [11][12][13] Ulnar variance was also measured. The x-rays taken at the time of the initial injury were also obtained and reviewed.…”

Section: Radiographic Measurementsmentioning

confidence: 99%