The effect of ulnar variance on scapholunate and capitolunate angles

Tosun, Özgür; Çilengir, Atilla Hikmet; Mete, Berna Dirim; Uluç, Muhsin Engin; Oyar, Orhan

doi:10.1177/0284185117692175

Cited by 5 publications

(9 citation statements)

References 16 publications

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“…The lateral wrist view on two-dimensional radiographs is crucial to diagnose many types of wrist pathology [10]. Although current radiography textbooks suggest performing this view with the central ray at the right angle, perpendicular Figure 3.…”

Section: Discussionmentioning

confidence: 99%

“…UV is also an important parameter commonly measured on the posteroanterior wrist radiographs as it plays a role in the distribution of forces across the wrist and is related to pathology such as disruption of the triangular fibrocartilage complex, carpal instability, scaphoid fractures, or Kienbock's disease [10]. The high frequency of obscuration of the radiocarpal joint by the ulnar styloid is understandable based on the anatomical alignment of the distal ulna with respect to the rest of the wrist.…”

Section: Discussionmentioning

confidence: 99%

“…Intuitively, factors that could influence the clinical utility of the L20 view include the radial angle tilt on the posteroanterior view (ie, if this varies substantially from 20 in a patient, a 20 angled lateral view may not be helpful), and the ulnar variance (UV). UV measurements from posteroanterior X-Rays are instrumental in diagnosing pathologies such as ulnocarpal impaction, and triangular fibrocartilage complex tears typically seen with positive UV, and Kienbock's disease which usually presents with negative UV [10]. We expect that for the L20 view, patients with positive UV would have the ulnar styloid process obscuring the radiocarpal joint, which is less likely to occur in patients with negative UV.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Toward an Improved Wrist View: Qualitative and Quantitative Investigation of the 20° Axial Lateral Wrist X-Ray

Gasheva

McHugh

Scharfenberger

et al. 2020

Journal of Medical Imaging and Radiation Sciences

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Toward an Improved Wrist View: Qualitative and Quantitative Investigation of the 20° Axial Lateral Wrist X-Ray

Gasheva

McHugh

Scharfenberger

et al. 2020

Journal of Medical Imaging and Radiation Sciences

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“…Standard MRI or MRI arthrography does not consistently diagnose all ligamentous tears[7, 46] and may show asymptomatic ligament defects that may have minimal clinical (or biomechanical) significance[47]. Thus, a real-time MRI exam could provide currently unavailable knowledge regarding wrist instability, and furthermore, show any clunk or sudden change in intercarpal alignment[48–50]. The real-time MRI exam is feasible as a supplement to a standard static MRI exam.…”

Section: Discussionmentioning

confidence: 99%

Real-time three-dimensional MRI for the assessment of dynamic carpal instability

et al. 2019

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BackgroundCarpal instability is defined as a condition where wrist motion and/or loading creates mechanical dysfunction, resulting in weakness, pain and decreased function. When conventional methods do not identify the instability patterns, yet clinical signs of instability exist, the diagnosis of dynamic instability is often suggested to describe carpal derangement manifested only during the wrist’s active motion or stress. We addressed the question: can advanced MRI techniques provide quantitative means to evaluate dynamic carpal instability and supplement standard static MRI acquisition? Our objectives were to (i) develop a real-time, three-dimensional MRI method to image the carpal joints during their active, uninterrupted motion; and (ii) demonstrate feasibility of the method for assessing metrics relevant to dynamic carpal instability, thus overcoming limitations of standard MRI.MethodsTwenty wrists (bilateral wrists of ten healthy participants) were scanned during radial-ulnar deviation and clenched-fist maneuvers. Images resulting from two real-time MRI pulse sequences, four sparse data-acquisition schemes, and three constrained image reconstruction techniques were compared. Image quality was assessed via blinded scoring by three radiologists and quantitative imaging metrics.ResultsReal-time MRI data-acquisition employing sparse radial sampling with a gradient-recalled-echo acquisition and constrained iterative reconstruction appeared to provide a practical tradeoff between imaging speed (temporal resolution up to 135 ms per slice) and image quality. The method effectively reduced streaking artifacts arising from data undersampling and enabled the derivation of quantitative measures pertinent to evaluating dynamic carpal instability.ConclusionThis study demonstrates that real-time, three-dimensional MRI of the moving wrist is feasible and may be useful for the evaluation of dynamic carpal instability.

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“…To date, these advances have been applied to investigate motion of the knee 16; 23; 24 and temporomandibular joint 25; 26 but not to carpal motion. For understanding, diagnosing and selecting appropriate treatment for dynamic instability of the carpus, there is increasing interest for dynamic imaging by hand surgeons and other clinicians [27][28][29] . There has also been a concern that fast gradient-echo based pulse sequences that worked well for other joints may not be technically feasible in the moving wrist because magnetic field inhomogeneities generated by the significant displacement of the tissues during motion may generate substantial artifacts 11 .…”

Section: Introductionmentioning

confidence: 99%

Real-time three-dimensional MRI for the assessment of dynamic carpal instability

Shaw

Foster

Borgese

et al. 2018

Preprint

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Carpal instability is defined as a condition where wrist motion or loading creates mechanical dysfunction, resulting in weakness, pain and decreased function. Often the diagnosis is made late when malalignment is visualized on static radiography, CT, or MRI. When conventional imaging methods do not identify the instability patterns, yet clinical signs associated with instability exist, the diagnosis of dynamic instability is often suggested to describe carpal derangement manifested only during the wrist’s active motion or stress. We addressed the question: can advanced MRI techniques provide quantitative measures for evaluating dynamic carpal instability and supplement standard static MRI acquisition? Our objectives were to [1] develop a real-time, three-dimensional MRI method to image the carpal joints during their active, uninterrupted motion; and [2] demonstrate feasibility of the method for assessing metrics relevant to dynamic carpal instability, thus overcoming limitations of conventional MRI. Twenty wrists (bilateral wrists of ten healthy participants) were scanned during radial-ulnar deviation and clenched-fist maneuvers. Images resulting from two real-time MRI pulse sequences, four sparse data acquisition schemes, and three constrained image reconstruction priors were compared. Image quality was assessed via blinded scoring by two radiologists and quantitative imaging metrics. Data acquisition employing sparse radial sampling with a gradient-recalled-echo acquisition and constrained iterative reconstruction (temporal resolution up to 135 ms per slice) appeared to provide a reasonable tradeoff between imaging speed and quality. This real-time MRI method effectively reduced streaking artifacts arising from data undersampling and enabled the derivation of quantitative measures pertinent to evaluating dynamic carpal instability.

show abstract

The effect of ulnar variance on scapholunate and capitolunate angles

Cited by 5 publications

References 16 publications

Toward an Improved Wrist View: Qualitative and Quantitative Investigation of the 20° Axial Lateral Wrist X-Ray

Toward an Improved Wrist View: Qualitative and Quantitative Investigation of the 20° Axial Lateral Wrist X-Ray

Real-time three-dimensional MRI for the assessment of dynamic carpal instability

Real-time three-dimensional MRI for the assessment of dynamic carpal instability

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